Cargando…

Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’

Snakebites are more frequent in the Brazilian Amazon than in other parts of Brazil, representing a high cost for the health system since antivenoms are only available through medical prescription from central municipal hospitals in most cases. The need for a cold chain and physicians usually restric...

Descripción completa

Detalles Bibliográficos
Autores principales: Monteiro, Wuelton Marcelo, de Farias, Altair Seabra, Val, Fernando, Neto, Alexandre Vilhena Silva, Sachett, André, Lacerda, Marcus, Sampaio, Vanderson, Cardoso, Deugles, Garnelo, Luiza, Vissoci, João Ricardo Nickenig, Sachett, Jacqueline, Wen, Fan Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762137/
https://www.ncbi.nlm.nih.gov/pubmed/33291444
http://dx.doi.org/10.3390/toxins12120772
_version_ 1783627733340782592
author Monteiro, Wuelton Marcelo
de Farias, Altair Seabra
Val, Fernando
Neto, Alexandre Vilhena Silva
Sachett, André
Lacerda, Marcus
Sampaio, Vanderson
Cardoso, Deugles
Garnelo, Luiza
Vissoci, João Ricardo Nickenig
Sachett, Jacqueline
Wen, Fan Hui
author_facet Monteiro, Wuelton Marcelo
de Farias, Altair Seabra
Val, Fernando
Neto, Alexandre Vilhena Silva
Sachett, André
Lacerda, Marcus
Sampaio, Vanderson
Cardoso, Deugles
Garnelo, Luiza
Vissoci, João Ricardo Nickenig
Sachett, Jacqueline
Wen, Fan Hui
author_sort Monteiro, Wuelton Marcelo
collection PubMed
description Snakebites are more frequent in the Brazilian Amazon than in other parts of Brazil, representing a high cost for the health system since antivenoms are only available through medical prescription from central municipal hospitals in most cases. The need for a cold chain and physicians usually restricts access to the only effective treatment of a snakebite, the antivenom. The complex topography of the rivers contributes to delays in treatment, and consequently increases the risk of severe complications, chronic sequelae and death. Thus, decentralization of antivenom treatment to primary healthcare facilities in the interior would increase access by indigenous population groups to proper healthcare. To standardize and evaluate the decentralization to low complexity indigenous healthcare units, we suggest the (i) development and validation of standardized operational procedures, (ii) training of professionals in the validated protocol in a referral health unit, (iii) implementation of the protocol in an indigenous healthcare unit, (iv) assessment of perceptions towards and acceptability of the protocol, and (v) estimation of the impact of the protocol’s implementation. We expect that antivenom decentralization would shorten the time between diagnosis and treatment and, as such, improve the prognosis of snakebites. As health cosmology among indigenous populations has an important role in maintaining their way of life, the introduction of a new therapeutic strategy to their customs must take into account the beliefs of these peoples. Thus, antivenom administration would be inserted as a crucial therapeutic tool in a world of diverse social, natural and supernatural representations. The information presented here also serves as a basis to advocate for support and promotion of health policy initiatives focused on evidence-based care in snakebite management.
format Online
Article
Text
id pubmed-7762137
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-77621372020-12-26 Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’ Monteiro, Wuelton Marcelo de Farias, Altair Seabra Val, Fernando Neto, Alexandre Vilhena Silva Sachett, André Lacerda, Marcus Sampaio, Vanderson Cardoso, Deugles Garnelo, Luiza Vissoci, João Ricardo Nickenig Sachett, Jacqueline Wen, Fan Hui Toxins (Basel) Review Snakebites are more frequent in the Brazilian Amazon than in other parts of Brazil, representing a high cost for the health system since antivenoms are only available through medical prescription from central municipal hospitals in most cases. The need for a cold chain and physicians usually restricts access to the only effective treatment of a snakebite, the antivenom. The complex topography of the rivers contributes to delays in treatment, and consequently increases the risk of severe complications, chronic sequelae and death. Thus, decentralization of antivenom treatment to primary healthcare facilities in the interior would increase access by indigenous population groups to proper healthcare. To standardize and evaluate the decentralization to low complexity indigenous healthcare units, we suggest the (i) development and validation of standardized operational procedures, (ii) training of professionals in the validated protocol in a referral health unit, (iii) implementation of the protocol in an indigenous healthcare unit, (iv) assessment of perceptions towards and acceptability of the protocol, and (v) estimation of the impact of the protocol’s implementation. We expect that antivenom decentralization would shorten the time between diagnosis and treatment and, as such, improve the prognosis of snakebites. As health cosmology among indigenous populations has an important role in maintaining their way of life, the introduction of a new therapeutic strategy to their customs must take into account the beliefs of these peoples. Thus, antivenom administration would be inserted as a crucial therapeutic tool in a world of diverse social, natural and supernatural representations. The information presented here also serves as a basis to advocate for support and promotion of health policy initiatives focused on evidence-based care in snakebite management. MDPI 2020-12-05 /pmc/articles/PMC7762137/ /pubmed/33291444 http://dx.doi.org/10.3390/toxins12120772 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Monteiro, Wuelton Marcelo
de Farias, Altair Seabra
Val, Fernando
Neto, Alexandre Vilhena Silva
Sachett, André
Lacerda, Marcus
Sampaio, Vanderson
Cardoso, Deugles
Garnelo, Luiza
Vissoci, João Ricardo Nickenig
Sachett, Jacqueline
Wen, Fan Hui
Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title_full Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title_fullStr Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title_full_unstemmed Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title_short Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’
title_sort providing antivenom treatment access to all brazilian amazon indigenous areas: ‘every life has equal value’
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7762137/
https://www.ncbi.nlm.nih.gov/pubmed/33291444
http://dx.doi.org/10.3390/toxins12120772
work_keys_str_mv AT monteirowueltonmarcelo providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT defariasaltairseabra providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT valfernando providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT netoalexandrevilhenasilva providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT sachettandre providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT lacerdamarcus providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT sampaiovanderson providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT cardosodeugles providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT garneloluiza providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT vissocijoaoricardonickenig providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT sachettjacqueline providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue
AT wenfanhui providingantivenomtreatmentaccesstoallbrazilianamazonindigenousareaseverylifehasequalvalue