Venomous snake bites in Lao PDR: a retrospective study of 21 snakebite victims in a provincial hospital.

This is a retrospective case series report of 21 snakebite victims admitted to a provincial hospital 80 km north of the capital city Vientiane between January 2007 and June 2008. There were 13 Malayan Pit Viper (MPV) and 6 Green Pit Viper (GPV) bites. Two patients could not identify the snake, but developed severe coagulopathy and were therefore most likely bitten by a MPV or GPV. Seven of 13 patients bitten by the MPV and 3 of 6 patients with GPV bites developed a coagulopathy; 2 patients bitten by a MPV had severe local signs of envenomation. The supply of antivenom was limited, thus only 6 patients received this treatment, although it was indicated in 12. The treatment was effective and the INR was normal or less than 3 within 24 hours. No early side effects occurred after injection of monospecific antivenom obtained from the Thai Red Cross. Antivenom is not available in most hospitals of the country and the majority of snakebite victims are still treated by traditional healers in the villages. Training of medical doctors and health workers in the management of snakebites is urgently needed to improve the outcome of this neglected disease in Lao PDR.