01669nas a2200193   4500000000100000008004100001260001600042653002100058653002500079653001500104653002600119100001500145700001600160245008800176300001400264490000800278520117500286022001401461       2023                            d  bElsevier BV10aGeneral Medicine10aSnakebite envenoming10aAntivenoms10aLow-resource settings1 aWarrell DA1 aWilliams DJ00aClinical aspects of snakebite envenoming and its treatment in low-resource settings  a1382-13980 v4013 a<p>There is increasing recognition of the public health importance of&nbsp;snakebite&nbsp;envenoming. Worldwide annual incidence is likely to be 5 million bites, with mortality exceeding 150 000 deaths, and the resulting physical and psychological morbidity leads to substantial social and economic repercussions. Prevention through community education by trained health workers is the most effective and economically viable strategy for reducing risk of bites and envenoming. Clinical challenges to effective treatment are most substantial in rural areas of low-resource settings, where snakebites are most common. Classic skills of&nbsp;history taking, physical examination, and use of affordable point-of-care tests should be followed by monitoring of evolving local and systemic envenoming. Despite the profusion of new ideas for interventions, hyperimmune equine or ovine plasma-derived&nbsp;antivenoms&nbsp;remain the only specific treatment for&nbsp;snakebite&nbsp;envenoming. The enormous interspecies and intraspecies complexity and diversity of&nbsp;snake venoms, revealed by modern venomics, demands a radical redesign of many current&nbsp;antivenoms.</p>
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