Frequency, geographical distribution and outcomes of pit viper bites in Malaysia consulted to Remote Envenomation Consultancy Services (RECS) from 2017 to 2020

• Published in: PLoS neglected tropical diseases 2023-08, Vol.17 (8), p.e0011569-e0011569
• Main Authors: Qamruddin, Reza Murad, Safferi, Ruth Sabrina, Mohamed@Ismail, Zainalabidin, Salleh, Mohd Shukruddeen, Abd Hamid, Muhammad Nadzmi Hadi, Frederic Ng, Vera Effa Rezar, Goh, Wan Chee, Ismail, Ahmad Khaldun
• Format: Article
• Language: English
• Subjects: Adults; Analysis; Antivenom; Biodiversity; Biological products; Biology and Life Sciences; Bites and stings; Consultancies; Consultancy services; Consulting services; Distribution; Epidemiology; Geographical distribution; Geographical locations; Geospatial data; Indigenous species; Injuries; International economic relations; Medicine and Health Sciences; Mortality; People and Places; Poisonous snakes; Population; Research ethics; Sampling methods; Snake bites; Tropical diseases; Venom; Young adults
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0011569

Not all pit viper species are present in every state of Malaysia and their distribution varies according to altitude. There is limited information on pit viper bite incidence and its geographical distribution. This was a cross-sectional study of confirmed pit viper bite cases referred to Remote Envenomation Consultancy Services (RECS) from January 2017 to December 2020. Data was collected following the approval of institutional research ethics committee. Universal sampling methods were used. Confirmed pit viper bite cases in each state, geographical location and the antivenom used were reported. A total of 523 confirmed pit viper bite injuries occurred over the 4-year study period. The majority were Malaysians, male and young adults. Most were non-occupational related (83.9%) and involved the upper limbs (46.8%). The commonest pit viper species involved was Trimeresurus purpureomaculatus (23.7%). Green pit viper antivenom (GPAV) was the most frequent antivenom used (n = 51) with the majority of patients requiring only one dose (3 vials). This study provides a better appreciation of indigenous pit viper species distribution for each state and reflects the requirement of appropriate antivenom to be stocked in each state or district hospital.