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Tes forensic  DNA forensik link  tanda gigitan ular pada korban ke spesies nya

Dimulai dengan swab DNA sederhana yang diambil dari  tanda fang  pada orang-orang  yang digigit ular , sebuah tim peneliti internasional mengidentifikasi dengan benar spesies dari gigitan  ular  dalam studi klinis pertama -dari-jenisnya .....read more

Forensic DNA test
conclusively links snake bite marks on people to species

Date:

November 4, 2014

Source:

Burness Communications

Summary:

Starting with a simple DNA swab taken from fang marks on people bitten by
snakes, an international research team correctly identified the species of the
biting snake 100 percent of the time in a first-of-its-kind clinical study.

..............................

Starting with a simple DNA swab taken from fang marks on people bitten by
snakes, an international research team correctly identified the species of the
biting snake 100 percent of the time in a first-of-its-kind clinical study,
according to data presented today at the American Society of Tropical Medicine
and Hygiene's (ASTMH) Annual Meeting.

The study, conducted at three medical facilities in Nepal, found that if
snake DNA could be isolated from the bite wound, the test identified the
species of snake responsible every time.

"These findings represent a significant step toward improving care for
patients in areas of the world where snakebites constitute a massive but
neglected health risk," said François Chappuis, MD, PhD, chief of the
division of tropical and humanitarian medicine at Geneva University Hospitals,
Switzerland, who directed the study and presented the results. "This DNA
test may hasten more effective bedside diagnostics for snakebite victims,
giving them a better chance of surviving and making a full recovery."

Bites from venomous snakes are common in many parts of the world and an
especially serious unresolved health problem to millions of people living in
South and Southeast Asia, as well as Africa and Latin America. Although there
are no reliable numbers at the global scale, a study published in 2008
estimated at least 421,000 cases of envenomation and up to 94,000 deaths occur
worldwide from snakebite each year. However, experts warn that these figures
may underestimate the real problem, which is believed to affect several million
people bitten by venomous snakes annually and hundreds of thousands who die or
survive disabled, suffering from amputation or deformed limbs as a result of
unavailable or delayed treatment.

In some villages of the study area of southeast Nepal reported today, a
community-based survey in 2002 revealed an estimated 1,162 snakebites and 162
snakebite deaths per 100,000 people per year, one of the highest rates ever
reported. Likewise, a recent survey of more than one million deaths in India,
published in the journal PLoS Neglected Tropical Diseases in 2011, found that 46,000
people die every year in India from snakebites. This figure is about 20 times
the official death toll recorded in Indian hospitals, most likely because less
than one in four fatal snakebite cases had received any hospital treatment, the
study revealed.

"People bitten by snakes in South Asia often do not seek treatment at
a medical facility, and if they do, the vast majority don't take the snake to
clinics, although it is often killed, and can't identify the species that bit
them," Chappuis said. "Yet knowing the species of snake is critical
to determining the best course of treatment."

In Nepal, for example, cobras and kraits are among the most common venomous
snakes. Their venoms attack the nervous system and can be fatal. Patients
bitten by either snake have similar symptoms, such as nausea, headache,
drowsiness and limb as well as respiratory paralysis. However, the toxins of
these snakes and their mechanisms of action differ, and so does the response to
antivenom and other drugs. For example, the locally available antivenom has
limited or no efficacy against krait envenomation, which often leads to useless
repeated doses resulting in increased cost and--possibly--adverse side effects,
explained Chappuis. Also, bites by cobras and kraits lead to different
complications that the attending physicians need to prevent or be prepared for.
Therefore, positive identification of the biting species becomes important to
effective treatment.

Preliminary results presented today show that among 194 bite-site DNA samples
collected in Nepal during the study, 87 were from a venomous species. The
spectacled cobra accounted for 42 bites and the common krait for 22. In 21
cases, the patients brought the dead snake with them, and in those cases expert
examination of the snake and the DNA test, performed by different
investigators, independently provided the correct identification. Snake DNA
could be obtained from about one in four bite wounds. According to the
researchers, one factor that excluded samples was if the patient attempted folk
or home remedies tampering with the bite site prior to arriving at the medical
clinic.

The research team also correlated clinical symptoms with the species biting
patients. They found that krait bites happened more often at night, indoors, or
while people were sleeping, while cobra or pitviper bites were more likely to
cause swelling at the bite site. The technique also identified several species
of non-venomous snake involved in bites.

"The proportion of non-venomous snakes that bite people is actually
rather high," said Ulrich Kuch, PhD, of the department of tropical
medicine and public health in the Institute of Occupational, Social and
Environmental Medicine of Goethe University (Frankfurt, Germany), and developer
of the snake DNA identification test. "Snakebite patients are kept in the
hospital for 24-hour observation, which strains healthcare resources in many
countries. By identifying species of nonvenomous snake, it is also possible to
assist the local people and avoid hospital stays for those not at risk of
envenomation."

The research team is currently developing a rapid diagnostic
"dip-stick" test similar to a pregnancy test that could be used to
rule out certain common venomous snakes and help physicians more quickly decide
the best course of treatment. Conversely, if for example, krait venom is
detected, doctors could quickly give antivenom instead of waiting for clinical
signs of envenomation, as is current practice. They would also accelerate the
transfer of patients to referral hospitals with intensive care units able to
ensure adequate respiratory support. Such a test would be easy to administer in
rural healthcare settings with limited resources, said Chappuis.

"That's where the recently developed DNA test could be most valuable,"
he added. While the DNA test is labor intensive and time consuming, making it
impractical for day-to-day clinical use, its high accuracy could allow it to
become a "gold standard" in clinical studies of rapid diagnostic
tests under development. In addition, the DNA test could become a powerful
epidemiological tool to determine which species of snake bite people in various
tropical regions.

"Knowing the distribution of snakes and the number of snakebites
within a region could help improve allocation of scarce antivenoms to areas
where they are most needed" said Chappuis.

The researchers have completed small clinical studies in Nepal and
Bangladesh and are preparing a larger multi-center clinical study using the DNA
test in Myanmar and Nepal, countries with among the highest rates of snakebite
deaths. The current study is funded by the UBS Optimus Foundation and the Swiss
National Fund.

"We need new tools in order to save more lives," said Sanjib K.
Sharma, MD, professor of medicine at the B.P. Koirala Institute of Health
Sciences in Nepal, and the principal investigator of the study. "There is
gross disparity in the management and outcome of snakebites since most occur in
rural, agricultural areas while the great majority of healthcare workers are in
urban locations."

"Most people are unaware that snakebite is a very real and serious
threat both to the health and economic vitality of rural communities throughout
much of the developing world," said Alan J. Magill, MD, FASTMH, president
of the American Society of Tropical Medicine and Hygiene. "This innovative
research may be enabling for the development of a point of care test to
positively identify biting snakes. Accurate diagnosis would go a long way
toward documenting the impact of snakebite and improving medical care for this
often neglected yet pervasive problem."







Story Source:

The above story is based on materials provided
by Burness Communications. Note:
Materials may be edited for content and length.

http://www.sciencedaily.com/releases/2014/11/141104091108.htm

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