Evidence map›Paper›PMID 40305592›Full record

ArticlePLoS neglected tropical diseases2025

Decentralization of snakebite antivenom treatment to indigenous community health centers in the Brazilian Amazon: From demand to the first treatment (the SAVING Program).

Altair Seabra de Farias, Thiago Serrão-Pinto, Deugles Cardoso, Elder Augusto Guimarães Figueira, Fernando Almeida-Val, Tatyana Amorim Ramos, Flávio Santos Dourado, Francisco Edilson Ferreira de Lima-Junior, Lucia Montebello, Manoel Rodrigues Gomes Filho and 11 more

Abstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Snakebite Envenomations In The Brazilian Amazon: A Little Less Neglected.Revista da Sociedade Brasileira de Medicina Tropical · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Altair Seabra de FariasSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Thiago Serrão-PintoSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Deugles CardosoDepartment of Environmental Surveillance, Fundação de Vigilância em Saúde do Amazonas Dra. Rosemary Costa Pinto, Manaus, Brazil.
Elder Augusto Guimarães FigueiraDepartment of Environmental Surveillance, Fundação de Vigilância em Saúde do Amazonas Dra. Rosemary Costa Pinto, Manaus, Brazil.
Fernando Almeida-ValSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Tatyana Amorim RamosDepartment of Environmental Surveillance, Fundação de Vigilância em Saúde do Amazonas Dra. Rosemary Costa Pinto, Manaus, Brazil.
Flávio Santos DouradoGeneral Coordination of Zoonoses and Vector-Borne Diseases Surveillance, Ministério da Saúde, Brasília, Brazil.
Francisco Edilson Ferreira de Lima-JuniorGeneral Coordination of Zoonoses and Vector-Borne Diseases Surveillance, Ministério da Saúde, Brasília, Brazil.
Lucia MontebelloGeneral Coordination of Zoonoses and Vector-Borne Diseases Surveillance, Ministério da Saúde, Brasília, Brazil.
Manoel Rodrigues Gomes FilhoDistrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.
Leonardo da Silva IpuchimaDistrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.
Nilzoney Ferreira de SouzaDistrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.
Macio da Costa ArévaloDistrito Sanitário Especial Indígena Alto Rio Solimões, Secretaria Especial de Saúde Indígena, Tabatinga, Brazil.
Marcus LacerdaSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Vinícius Azevedo MachadoSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Felipe MurtaSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Charles GerardoDepartment of Emergency Medicine, Department of Surgery, Duke University, Durham, North Carolina, United States of America.
João VissociDepartment of Emergency Medicine, Department of Surgery, Duke University, Durham, North Carolina, United States of America.
Fan Hui WenBioindustrial Center, Butantan Institute, São Paulo, Brazil.
Jacqueline SachettSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.
Wuelton MonteiroSchool of Health Sciences, Universidade do Estado do Amazonas, Manaus, Brazil.ORCID 0000-0002-0848-1940

Funding

Brazilian Ministry of HealthConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fogarty International Center of the National Institutes of Health R21TW011944Fundação de Amparo à Pesquisa do Estado do AmazonasMedical Research Council-United Kingdom MR/Y019709/1
6 · The paper itself

Abstract

Brazilian antivenoms have excellent efficacy in recovering venom-induced coagulopathy, in addition to having a good safety profile with only 10% of patients experiencing a mild reaction such as urticaria or pruritus. More than 3.5 hundred thousand snakebite antivenom vials are produced per year, and all the batches are acquired by the Ministry of Health and distributed free of charge to 2,200 hospitals across the national territory. However, these health facilities are unevenly distributed across the territory, so that the distance a patient needs to travel to receive care is much greater in the Amazon region in comparison to the extra-Amazonia region, leading to a huge access barrier in this region. The lack of access to healthcare facilities for snakebite patients may be greater than 30% in some regions of the Amazonia. The decentralization of SBE treatment with antivenoms to the scope of indigenous community health centers requires the discussion of proper organizational designs and arrangements of practices based on the user needs, singularities of the territory, and the clinical reality of the indigenous populations. In this report, we describe a successful experience of decentralization of antivenom treatment for an indigenous health unit in the Brazilian Amazon, which provides a platform to improve the lives of SBE patients at risk of this life-threatening condition. In this work, we report the experience in the development and implementation of a program to decentralize antivenom treatment for indigenous communities, which represents a significant change in the national policy for snakebite control, with a potential impact on reducing morbidity and mortality from this health problem. In the next steps, SAVING Program will be evaluated through mixed-method studies in regards team and community's experience within the program, aiming to identify barriers, perceptions about the implementation process, and facilitators for the maintenance/sustainability.

Indexed as

AntiveninsCommunity Health CentersSnake BitesAdultBrazilFemaleHealth Services AccessibilityHumansMaleAntivenins

Identifiers

PMID40305592
PMCPMC12043230

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.