ArticleTropical medicine and health2026
Outcomes of venom-induced consumption coagulopathy following snakebite envenoming in Sudan: a cohort study.
Article in Tropical medicine and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSnakebite envenomation (SBE) is a major neglected tropical diseases, causing significant morbidity and mortality, particularly in sub-Saharan Africa. Venom-induced consumption coagulopathy (VICC) is a major systemic complication and leading cause of death in haemotoxic snakebite. In Sudan, SBE is underreported, and data on VICC in resource-limited settings remain scarce. This study aimed to determine the incidence, clinical and laboratory characteristics, management, and in-hospital outcomes of VICC in SBE patients, and to evaluate the performance of the 20-min whole blood clotting test (WBCT20) as a bedside screening tool.
methodsA hospital-based observational cohort study was conducted at Sinja Teaching Hospital, Sudan (15 March-15 September 2022). All consecutive SBE patients were included (n = 119). VICC was defined as INR ≥ 1.4 with prolonged PT and/or APTT. Data were collected using a structured questionnaire and routine clinical records. All patients underwent WBCT20 and standard coagulation testing. Outcomes included in-hospital mortality, acute kidney injury (AKI), severe haemorrhage, and length of stay. Analysis was descriptive using SPSS v25.
resultsOf 119 patients, 96 (80.7%) developed VICC. Most were young male farmers with lower limb bites (88.2%). Suspected Echis spp. accounted for 86.6% of cases. Spontaneous bleeding occurred in 88.5% of VICC patients, and severe haemorrhage in 30.2%, most commonly intracerebral bleeding. AKI occurred in 29.4% of all patients and only in those with VICC. WBCT20 was positive in all VICC cases (sensitivity 100%) and showed specificity of 89.6%, with 10 cases positive despite INR < 1.5, suggesting early coagulopathy. In-hospital mortality among VICC patients was 30.2%. All VICC patients received fresh frozen plasma, with clinical and laboratory improvement in 69.8%, though no comparative efficacy analysis was performed.
conclusionsVICC is highly prevalent among hospitalized SBE patients in this setting and is associated with major complications and high mortality. WBCT20 is a sensitive bedside tool but requires confirmation with laboratory testing. Findings highlight gaps in antivenom coverage, the need for species-appropriate therapy, and strengthened surveillance and prospective studies to improve snakebite management in Sudan.
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