Table 4. Snake species with haemorrhagic (haematotoxic) manifestations in humans [23, 24].

Common name	Habitat/habit	Other toxins	Clinical manifestation	Antivenom availability
West African Carpet Viper (Echis ocellatus)**	Terrestrial, nocturnal and crepuscular	Anticoagulants, Nephrotoxins, Mixture of procoagulants, Necrotoxins,	Renal complication, secondary to coagulopathy, Marked local effects (pain, severe swelling, bruising, blistering), Moderate to severe necrosis	SAIMR Echis Antivenom, FAV-Afrique, Pan-African antivenom (EchiTAb-Plus-ICP), EchiTAbG, Antivipmyn Africa, SAIMR Echis antivenom
West African Green Tree Viper (Atheris chloroechis)*	Forest, semi-arid areas, Diurnal and arboreal		Severe envenoming possible, potentially lethal, Local pain, swelling, bruising & blistering, Coagulopathy & hemorrhages are uncommon to rare, but may be moderate to severe coagulopathy	No Antivenoms
Puff adder (Bitis arietans)*	Savanna, nocturnal	Procoagulants Anticoagulants Nephrotoxins Necrotoxins+	Marked local effects; pain, severe swelling, bruising, blistering, Moderate to severe local Necrosis, Common, moderate to severe coagulopathy + haemorrhagins causing extensive bleeding, Cardiotoxicity is common and is major clinical effect, Shock secondary to fluid shifts due to local tissue injury is likely in severe cases	SAIMR Snakebite Kit, Antivipmyn Africa, Pan-African antivenom (EchiTAb-Plus-ICP), Polyvalent Snake Venom Antiserum, FAV-Afrique, Favirept, SAIMR Polyvalent Antivenom
Gaboon Viper (Bitis rhinoceros)**	Forest, nocturnal	Procoagulants, Fibrinogenases) Anticoagulants Cardiotoxins+ Necrotoxins+	Marked local effects; pain, severe swelling, bruising, blistering, Minor neurotoxic paralysis, Coagulopathy & Haemorrhages, very common, coagulopathy + haemorrhagins causing bleeding is major clinical effect, Cardiotoxicity common,	FAV-Afrique, Antivipmyn Africa, Polyvalent Snake Venom Antiserum SAIMR Polyvalent Antivenom SII Polyvalent
Boomslang (Dispholidus typus*)	Open bush, savannah, wooded grassland, Diurnal and arboreal	Procoagulants Anticoagulants	Local pain, swelling & bruising Coagulopathy & Haemorrhages Common, moderate to severe coagulopathy + haemorrhagins causing extensive bleeding	SAIMR Boomslang Antivenom

[+ = present but not defined

* = WHO category 1—Highest medically important venomous snakes

** = WHO category 2—Secondary medically important highly venomous snakes].