As a recent guest of Professor Khin Maung Htay at Yangons Thingangyun San Pya Hospital and Yangon Specialist Hospital, I was exposed to how snake bites are a major health concern in Myanmar, especially for kidney patients.
In 2012, there were almost 14,000 reported snake bites in Myanmar, 2% were fatal. Last year, out of 143 acute kidney injury (AKI) cases in Thingangyun San Pya Hospital, 89 of them were caused by snake bites.
Anti-venom is very effective if given early. Dialysis patients generally receive acute peritoneal dialysis via a hard catheter inserted using a trocar.
Dr Khin Thida Thwin showed me around Yangon Specialist Hospitals renal unit, which she directs. It is a snake bite research and referral center.
Out of 2,000 admissions in 2015, 27% were AKI related, and more than half of these cases were due to snake bites.
The mortality rate amongst kidney disease patients is about 5-15%, compared to 2% for all cases of snake bite. About 10% develop panhypopituitarism because of disseminated intravascular coagulation, while a smaller number develop acute respiratory distress syndrome, which is almost always fatal.
Thingangyun Sanpya Hospitals renal unit was established in 1991 and provides acute and chronic hemodialysis to over one hundred patients, as well as acute peritoneal dialysis services. In a few years, it will start renal transplantation.
Further reading in Kidney International on snake-bite-induced AKI
Acute renal failure after Crotalus durissus snakebite: A prospective survey on 100 patients
Snake-bite-induced acute renal failure in India
The team at Thingangyun San Pya General Hospital, (left to right): Prof Htay, Dr Kyaw Thiha Soe , David Harris, Associate Professor Thuzar Thin, Dr Yi Yi Khine and Dr Chaw Chaw Ei.
Group photo at Yangon Specialist Hospital (left to right): Dr Yin Yin Mon, Dr Yee Yee Myint, Associate Professor Khin Khin Win, Associate Professor Win Win Hlaing, Dr Su Thet Ko, Professor Htay, David Harris, Professor Khin Thida Thwin, Dr Mya Htwe Ngal and Dr Ngu Wah Wah Min.