Economic Evaluations of Interventions for Snakebites: A Systematic Review

Figures & data

Figure 1 Search flowchart and selection of studies.

Table 1 Description of the Studies According to Year, Country, Population, and Study Alternatives

Author	Year	Country	Population	Interventions	Outcome
Weant et al^Citation11	2012	United States	75 patients (30 treated and 45 controls)	Standardized use of AV	Days of hospitalization and in the ICU
Qureshi et al^Citation14	2013	Pakistan	80 patients (40 per arm)	AV Pakistan AV India	Coagulation control and adverse reactions
Habib et al^Citation12	2015	Nigeria	Total modeling of country cases	AV availability or not	Deaths and DALYs avoided
Hamza et al^Citation15	2016	16 African countries	Total modeling of cases by country	AV availability or not	Deaths and DALYs avoided
Kasturiratne wet al^Citation16	2017	Sri Lanka	49,819 patients without envenoming and 30,458 patients with envenoming	Case management with AV	Hospitalization and DALYs
Herzel et al^Citation17	2018	United States	100 patients	AV + Care AV + Adjuvant + Care	DALYs
Magalhães et al^Citation18	2020	Brazil	11,503 cases and 56 deaths	AV + Care	Cost to the health system, due to premature death and attributed to the loss of productivity

Abbreviation: AV, antivenom.

Figure 2 Evaluation of the methodological quality of the studies.

Figure 3 Average cost-effectiveness analysis of antivenom treatment for deaths and DALYs avoided. “a” indicates AV + Envenoming management. “b” indicates AV + Support. “c” indicates AV + Adjuvant.

Weant KA, Bowers RC, Reed J, Braun KA, Dodd DM, Baker SN. Safety and cost-effectiveness of a clinical protocol implemented to standardize the use of Crotalidae polyvalent immune Fab antivenom at an academic medical center. Pharmacotherapy. 2012;32:433–440. doi:10.1002/j.1875-9114.2012.01026.x

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Qureshi H, Alam SE, Mustufa MA, Nomani NK, Asnani JL, Sharif M. Comparative cost and efficacy trial of Pakistani versus Indian anti snake venom. J Pak Med Assoc. 2013;63:1129–1132.

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Habib AG, Lamorde M, Dalhat MM, Habib ZG, Kuznik A, Lalloo DG. Cost-effectiveness of antivenoms for snakebite envenoming in Nigeria. PLoS Negl Trop Dis. 2015;9:e3381. doi:10.1371/journal.pntd.0003381

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Hamza M, Idris MA, Maiyaki MB, et al. Cost-effectiveness of antivenoms for snakebite envenoming in 16 countries in West Africa. PLoS Negl Trop Dis. 2016;10:e0004568. doi:10.1371/journal.pntd.0004568

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Kasturiratne A, Pathmeswaran A, Wickremasinghe AR, et al. The socio-economic burden of snakebite in Sri Lanka. PLoS Negl Trop Dis. 2017;11:e0005647. doi:10.1371/journal.pntd.0005647

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Herzel BJ, Samuel SP, Bulfone TC, Raj CS, Lewin M, Kahn JG. Snakebite: an exploratory cost-effectiveness analysis of adjunct treatment strategies. Am J Trop Med Hyg. 2018;99:404–412. doi:10.4269/ajtmh.17-0922

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Magalhães SFV, Peixoto HM, de Almeida Gonçalves Sachett J, et al. Snakebite envenomation in the Brazilian Amazon: a cost-of-illness study. Trans R Soc Trop Med Hyg. 2020;traa005. doi:10.1093/trstmh/traa005

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