The main aim of the proposed project isto investigate further the problems caused by venomous bites and stings in Brazil. The previous study concentrated primarily on the assessment of Brazilian Bothrops antivenoms in moderately envenomed patients. The main aims of the present study will be to (1) examine the problems of envenoming and therapy in severly envenomed victims bitten by the main species of medical importance in the country, using clinical and laboratory methods to establish the optimal antivenom dose, the effect of antivenom in reducing both the extent of swelling and local necrosis, severe problems in snake bite envenoming, is remedied by antivenom treatment. These aspects will be thoroughly investigated, as well as will the problem of possible pituitary and adrenal insufficiency caused by pituitary infarction, (2) to evaluate current first aid procedures, such as the use of tourniquets in systemic envenoming, this is a highly controversial subject in many parts of the world, (3) to evaluate early surgery for digital bites to answer one of the main questions of ancillery management of snake bite, (4) to critically appraise the effect of prophylactic antimicrobial drugs in reducing the secondary infection caused by bites and stings, (5) to investigate the use of prophylactic antihistamines in reducing theextent of both early and late antivenom reactions in patients, (6) to continue to assess and develop a rapid immunoassay for epidemiological and diagnostic investigations, (7) to investigate the problems of spider and scorpion sting in patients, (8) to correct the severe problems in toxonomic identification in medically important snake species, and (9) to apply these studies for the first time as part of a detailled investigation of the problem in indegenous Indian populations in northern Brazil.
The succes of the programme will depend on the excellent collaboration from associated European and Brazilian institutions which was so important for the success of the last project. The importance of the training component written in to this proposal cannot be underestimated, as this will hopefully result im stimulating the interest in an important, but neglected, medical problem in the rural tropics.
Funding SchemeCSC - Cost-sharing contracts
05504 São Paulo
OX3 9DU Oxford/headington
LL57 2UW Bangor - Gwynedd
30190 Belo Horizonte