A retrospective study has been performed on
snakebites from January 1993 to December 2002 in the national hospitals Gabriel-Touré, in Bamako, and Kati. It aimed to establish a synthesis of epidemiological, clinical, and therapeutic aspects from
snakebites. Eight hundred thirty-two
snakebites were recorded during this period. Men were mostly represented: 72 versus 28% of women. The average age was 28 ± 18 years. Farmers were most affected (28%). Most
bites occurred between 16 and 20 hours, during the fieldwork and pasture in 44% cases. Lower limbs (73.8%) were more involved than hands (25.8%). Although the type of snake has not been determined, the clinical picture was that of viper syndrome, the severity of which was assessed by the grade of
bleeding,
edema, renal involvement (15.8%), and
neurological disorders (13.3%).
Antivenom was administered to 40.6% of patients whose case fatality rate was 2.8%, whereas it was 8.1% in its absence. The case fatality rate associated with serum
therapy varied according to the
antivenin, 1.5% with the
antivenoms manufactured in Europe and 4% with those manufactured in Asia. Five parturients had a favorable outcome with
antivenom. The initial management was carried out by traditional healers in 49.7% of cases. The annual case fatality rate decreased gradually from 12% in 1995 to 3% in 2002. The incidence of
snakebite is greatly underestimated in hospitals because of inadequate records.