Table 1.

Patient Characteristics

First author, year of publication, study design	Patient number, age, gender,profession	Region of Cameroon and site of the incident	Site of snake bite on the body	Snake species	Delay before hospital presentation	Signs of envenomation	Management	Outcome
Nkwescheu [10], 2016, case report	Patient 1; 28 year, male, physician	Northern Cameroon, in bedroom	Right hand	Naja melanoleuca	Within an hour	Swollen hand, rigors, foaming at the mouth, loss of speech and severe respiratory distress.	One vial AVS, Fluid resucitation, Atropine 1 mg IV, Ranitidine 50 mg IV, Paracetamol 500 mg IV.	fatal
Tianyi, 2017 [11], case report	Patient 2: 10 years, female, occupation not precised	Adamawa region, in the farm	Right temple	Unidentified snake species	12 h	Marked facial swelling, haematuria, pain, bleeding from the wound and mouth, mild respiratory distress.	Topical application and oral ingestion of herbal concoctions, 1 vial of AVS, 1500 IU anti-tetanus serum SC, dexamethasone 4 mg IV every 8 h, ceftriaxone 450 mg every 12 h, wound dressing, Normal saline 100 ml/h.	Complete recovery
Tianyi, 2018[12], case series of two patients	Patient 3: 80 years, male, traditional healer	Adamawa region, in the bush	Left leg	Naja melanoleuca	Died on the way to the hospital	Inability to stand, and difficulties in speaking, loss of consciousness.	Application of traditional topical ointments on the wounds, ingestion of herbal concoctions, no AVS administered.	fatal
	Patient 4: 3 years, female	Adamawa region, in the bush	Left leg	Unidentified snake species	Four hours	Inability to stand, talk and open her eyes, breathing difficulties, convulsion, a state of shock.	Tourniquet applied on left thigh, fluid resuscitation, 750 IU anti-tetanus serum SC, dexamethazone 4 mg IM, AVS not available.	fatal
The present case report	Patient 5: 47 years old female farmer	Centre region, in the farm	Right thumb	Echis occellatus	20 h	a state of shock, acute kidney injury, coagulopathy and gangrene.	Topical application and oral ingestion of herbal, concoctions, fluid resuscitation, anti-tetanus serum 1500 IU SV, ceftriaxone 2 g/24 h IV, metronidazole 500 mg/8 h IV, adrenaline 1:1000 dilution at 0.2 mg every 5 min IV, promethazine 25 mg/8 h IV, Paracetamol 1 g/06 h IV, tramadol 100 mg/8 h IV, methylprednisolone 80 mg/kg IV, three vials of polyvalent anti-venom sera IV, Noradrenaline 0.3/kg/min using EPS, and transfusion of three units of fresh frozen plasma.	fatal

AVS: anti-venom serum; SC: subcutaneous; IV: intravenous; IM: intramuscular; EPS: Electric pump syringe