Assessment of Inflammatory and Cardiac Status of Echis ocellatus Snake-bite Victims in Jos Metropolis, Plateau State, Nigeria
P. O. Manafa
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
G. C. Jackson Njoku
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
C. C. Onyenekwe
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
O. Ekuma-Okereke *
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
E. E. Nnadi
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
R. S. Ebugosi
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
G. O. Chukwuma
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
E. C. Onah
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
R. C. Chukwuanukwu
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
K. E. Nwene
Center for Clinical Research in Nigeria, Enugu State, Nigeria.
V. I. Manafa
Department of Pathology and Clinical Biochemsitry, East Kent Hospitals University NHS Foundation Trust, United Kingdom.
O. S. Ogbuowelu
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, Nnamdi Azikiwe University, Nnewi Campus, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: This study was designed to evaluate the inflammatory and cardiac status of snakebite victims using serum levels of C-reactive protein (CRP), troponin-I (TnI), total cholesterol (TC) and triglycerides (TG) as markers in Echis ocellatus snakebite victims before and after administration of EchiTAb-G antivenom.
Materials and Methods: A total of 80subjects (40 Echis ocellatus bite victims and 40 apparently healthy indivuals as test and control subjects respectively) were purposively recruited for this study. Venous blood samples were collected within 4hours after bite. The whole blood clotting time (WBCT20) was determined immediately. Another batch of samples were collected from same snakebite victims, 2days post administration of the anti-venom. CRP and Troponin-I levels were evaluated using the enzyme linked immunosorbent assay technique while serum total cholesterol, and triglyceride levels were assayed spectrophotometrically.
Results: The mean serum levels of troponin-I (2.98±5.75) and CRP (36.64±29.01) were significantly higher in Echis ocellatus bite victims before administration of anti-venom compared with control subjects (0.007±0.3 and 0.99±0.28) and after post administration of anti-venom (0.16±1.39 and 15.96±17.36) (P<0.05) respectively. Conversely, the mean plasma levels of total cholesterol and triglyceride were significantly lower (p<0.05) in snake bite subjects before anti-venom administration when compared with control and snake bite subjects after post administration of anti-venom. Furthermore, the mean serum levels of troponin-I and CRP correlated significantly positive when correlated between snake bite subjects before (r=0.498, p=0.001) and after (r=0.430, p=0.006) anti-venom administration respectively.
Conclusion: The research findings therefore suggest that Echis ocellatus envenomation triggers inflammatory reaction which could be the reason behind the alteration in cardiac markersas evidenced by the significant elevations in serum troponin-I and CRP levels amongst snake bite victims compared to the non-snake bite control groups thus, could cause cardiac arrest before anti-venom administration.
Keywords: Echis ocellatus venom, snakebite, inflammation, C-reactive protein, cardiac markers, troponin-I, total cholesterol, triglycerides.