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

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Department of Medicine and Nursing, School of Health Sciences, Amazonas State University, Manaus 69065-001, Amazonas, Brazil
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Department of Teaching and Research, Dr. Heitor Vieira Dourado Tropical Medicine Foundation, Manaus 69040-000, Amazonas, Brazil
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Instituto Leônidas & Maria Deane, Fiocruz, Manaus 69057-070, Amazonas, Brazil
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Technical Department, Amazonas Health Surveillance Foundation, Manaus 69093-018, Amazonas, Brazil
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Division of Emergency Medicine, Department of Surgery and Duke Global Health Institute, Duke University, Durham, NC 27710, USA
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Department of Teaching and Research, Alfredo da Matta Foundation, Manaus 69065-130, Amazonas, Brazil
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Bioindustrial Centre, Butantan Institute, Butantã 05503-900, São Paulo, Brazil
*
Author to whom correspondence should be addressed.
Toxins 2020, 12(12), 772; https://doi.org/10.3390/toxins12120772
Received: 26 October 2020 / Revised: 28 November 2020 / Accepted: 29 November 2020 / Published: 5 December 2020
(This article belongs to the Special Issue Novel Strategies for the Diagnosis and Treatment of Snakebites)
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. View Full-Text
Keywords: snakebite; antivenom; indigenous groups; health service; health decentralization snakebite; antivenom; indigenous groups; health service; health decentralization
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MDPI and ACS Style

Monteiro, W.M.; Farias, A.S.d.; Val, F.; Neto, A.V.S.; Sachett, A.; Lacerda, M.; Sampaio, V.; Cardoso, D.; Garnelo, L.; Vissoci, J.R.N.; Sachett, J.; Wen, F.H. Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’. Toxins 2020, 12, 772. https://doi.org/10.3390/toxins12120772

AMA Style

Monteiro WM, Farias ASd, Val F, Neto AVS, Sachett A, Lacerda M, Sampaio V, Cardoso D, Garnelo L, Vissoci JRN, Sachett J, Wen FH. Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’. Toxins. 2020; 12(12):772. https://doi.org/10.3390/toxins12120772

Chicago/Turabian Style

Monteiro, Wuelton M., Altair S.d. Farias, Fernando Val, Alexandre V.S. Neto, André Sachett, Marcus Lacerda, Vanderson Sampaio, Deugles Cardoso, Luiza Garnelo, João R.N. Vissoci, Jacqueline Sachett, and Fan H. Wen 2020. "Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: ‘Every Life has Equal Value’" Toxins 12, no. 12: 772. https://doi.org/10.3390/toxins12120772

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