Assessment of the levels of some haemostatic profiles in snakebite victims attending the snakebite research, training and treatment centre Kaltungo, Gombe State Nigeria

Abstract

Background: Coagulopathy is one of the major clinical issues associated with haemotoxic effect of envenomation due to snakebite.  Coagulopathy in snakebite could results to decrease platelets count, prolonged Prothrombin Time (PT), International Normalized Ratio  (INR), Thrombin Time (TT), Activated Prothromboplastin Time Test (APTT), and Fibrinogen level. It is also associated with increase in  proteins C and S as well as D-dimer levels. This study was aim to evaluate some haemostatic profile of snakebite victims.

Methods: Two hundred (200) snakebite victims and one hundred (100) controls subjects were recruited in this study for the period of 8  months (October, 2020 to May, 2021). A total of 8m of whole blood was collected and dispensed into (2ml) of the blood was dispensed  into Ethylene Diamine-Tetra Acetic acid {EDTA (2ml)} container for Platelet count as part of Full Blood Count, 4ml into a container  containing 0.5ml sodium citrate for clotting profile (PT, INR, APTT, TT and fibrinogen) and another 2mlinto lithium heparin container for  D-dimer assay. Haematology analyzer (McJefferson’s haematology analyzer) was used for FBC and the coagulation parameters were  determined using semi automated coagulation machine (Stago-Start Max).

Results: There was significant decrease in platelet count with  p-value of 0.0001, significant increase in PT, INR, APTT, TT and fibrinogen levels; all with p-values of 0.0001. On the other hand, there was  significant increase in protein C and S as well as Ddimer levels with p-values 0.0001). A p-value of less than 0.05 (p<0.05) was considered significant for all the parameters.

Conclusion: The findings from this study shows that snakebite coagulopathy greatly affects platelet  count, PT, INR, APTT, TT, Fibrinogen, protein C and S as well as D-dimer levels. Hence, a major cause of coagulopathy in snakebite victims,  resulting many complications and even death.