<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-4157</journal-id>
<journal-title><![CDATA[Biomédica]]></journal-title>
<abbrev-journal-title><![CDATA[Biomed.]]></abbrev-journal-title>
<issn>0120-4157</issn>
<publisher>
<publisher-name><![CDATA[Instituto Nacional de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-41572023000100093</article-id>
<article-id pub-id-type="doi">10.7705/biomedica.6587</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Epidemiología y características clínicas de las mordeduras de serpientes venenosas en el norte de la Amazonía del Ecuador (2017-2021)]]></article-title>
<article-title xml:lang="en"><![CDATA[Epidemiology and clinical features of venomous snake bites in the Northern Amazon of Ecuador (2017-2021)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Calvopiña]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Guamán-Charco]]></surname>
<given-names><![CDATA[Elías]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[Karen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dávalos]]></surname>
<given-names><![CDATA[Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chiliquinga]]></surname>
<given-names><![CDATA[Paola]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villa-Soxo]]></surname>
<given-names><![CDATA[Sergio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oña-Vistin]]></surname>
<given-names><![CDATA[René]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero-Álvarez]]></surname>
<given-names><![CDATA[Daniel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de las Américas  ]]></institution>
<addr-line><![CDATA[Quito ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Ministerio de Salud Pública  ]]></institution>
<addr-line><![CDATA[Nueva Loja Sucumbíos]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Ministerio de Salud Pública  ]]></institution>
<addr-line><![CDATA[Nueva Loja Sucumbíos]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Kansas  ]]></institution>
<addr-line><![CDATA[Lawrence KS]]></addr-line>
<country>USA</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2023</year>
</pub-date>
<volume>43</volume>
<numero>1</numero>
<fpage>93</fpage>
<lpage>107</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-41572023000100093&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-41572023000100093&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-41572023000100093&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción.  En Ecuador, las mordeduras de serpientes venenosas son un problema de salud pública. Sin embargo, no existe información hospitalaria reciente desde la Amazonía.  Objetivo.  Analizar retrospectivamente las características clínico-epidemiológicas de las mordeduras de serpientes en pacientes ingresados en un hospital de la Amazonía del Ecuador.  Materiales y métodos.  Se llevó a cabo un estudio transversal en el hospital provincial de Nueva Loja (Sucumbíos), que colinda con Colombia, 2017-2021. La información sobre las variables demográficas, epidemiológicas y clínicas, y la condición al egreso hospitalario, se obtuvieron de la ficha epidemiológica del Ministerio de Salud Pública.  Resultados.  En cinco años se hospitalizaron 147 pacientes (29,4 por año), sin que se presentaran muertes. Corresponden a 26, 34, 32, 29 y 26 casos, en el 2017, 2018, 2019, 2020 y 2021, respectivamente. Según el sexo, los más afectados fueron los hombres (n=99; 67,3 %), según el grupo etario, los de 21 a 30 años (n=28; 19,0 %) y, según la raza, los de etnia mestiza (n=94; 63,9 %), estudiantes y agricultores. La mediana de edad fue de 28 años (rango: 4 a 81). Hubo mayor prevalencia en abril, junio y septiembre. Todos los accidentes fueron causados por serpientes Viperidae. Veinte (13,6 %) casos fueron leves, 90 (61,2 %), moderados, y 37 (25,2 %), graves. La mordedura fue más frecuente en los pies (45 casos). El 53,1 % recibió suero antiofídico antes de la hospitalización y en el 19,8 % de los pacientes se colocó un torniquete. La mediana de tiempo de llegada al hospital fue de 5 horas (rango: 1-192), y lo más frecuente fue entre 2 y 3 horas (41 casos). No se encontraron diferencias estadísticamente significativas según la gravedad del caso.  Conclusiones.  Se evidenció una gran prevalencia de mordeduras de serpientes en el norte de la región amazónica-Ecuador, con mayor incidencia en la estación lluviosa y todas causadas por Viperidae. Es importante resaltar la mortalidad nula. Las campañas informativas sobre prevención y primeros auxilios, como la desmotivación del uso de torniquetes, serían fundamentales para reducir los casos, especialmente, en los grupos vulnerables.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  In Ecuador, poisonous snakebites are a public health problem. However, there is no recent hospital information from the Amazon.  Objective:  To retrospectively analyse the clinical-epidemiological characteristics of snakebites in patients admitted to a hospital in the Ecuadorian Amazon.  Materials and methods:  This is a cross-sectional study conducted at the Nueva Loja-Sucumbíos Provincial Hospital, bordering Colombia (2017-2021). Demographic, epidemiological and clinical variables, and condition at hospital discharge, were obtained from the epidemiological file of the Ministerio de Salud Pública.  Results:  In 5 years, 147 patients (29.4 per year) were hospitalized with no mortality. They corresponded to 26, 34, 32, 29 and 26 cases, in 2017, 2018, 2019, 2020 and 2021, respectively. Men with 99 (67.3%), aged 21-30 years with 28, mixed race with 94 cases, students, and farmers, were the most affected. The most affected (99; 67.3%) were men, people 21 to 30 years-old (28; 19.0%), mestizos (94; 63.9%), students, and farmers. The median age was 28 (range: 4-81) years. Prevalence was higher in April, June, and September. All accidents were caused by Viperidae snakes. Twenty (13.6%) cases were mild, (61.2%) were moderate and 37 (25.2%) were severe. The feet with 45 were the most bitten. Pre-hospitalization anti-venom serum was received by 53.1% and tourniquet by 19.8% patients. Median hospital arrival time was 5 (range 1-192) hours, mostly between 2-3 hours with 41 cases. No statistically significant differences were found considering the severity.  Conclusions:  A high prevalence of snakebites was evidenced in the north of the Amazon in Ecuador, with a higher incidence in the rainy season and all by Viperidae species. It is important to highlight the null mortality. Information campaigns on prevention and first aid, such as discouraging the use of tourniquets, especially among vulnerable groups.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[mordeduras de serpientes/epidemiología]]></kwd>
<kwd lng="es"><![CDATA[animales venenosos]]></kwd>
<kwd lng="es"><![CDATA[ecosistema Amazónico, Ecuador]]></kwd>
<kwd lng="en"><![CDATA[Snake bites/epidemiology]]></kwd>
<kwd lng="en"><![CDATA[animals, poisonous]]></kwd>
<kwd lng="en"><![CDATA[Amazonian ecosystem]]></kwd>
<kwd lng="en"><![CDATA[Ecuador]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>World Health Organization</collab>
<source><![CDATA[Snakebite envenoming]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Faiz]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Abela-Ridder]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Ainsworth]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Bulfone]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[Nickerson]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Strategy for a globally coordinated response to a priority neglected tropical disease: Snakebite envenoming]]></article-title>
<source><![CDATA[PLoS Negl Trop Dis]]></source>
<year>2019</year>
<volume>13</volume>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Varela]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Ron]]></surname>
<given-names><![CDATA[SR.]]></given-names>
</name>
</person-group>
<source><![CDATA[Geografía y clima]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yáñez-Arenas]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz-Gamboa]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Patrón-Rivero]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[López-Reyes]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Chiappa-Carrara]]></surname>
<given-names><![CDATA[X.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estimating geographic patterns of ophidism risk in Ecuador]]></article-title>
<source><![CDATA[Neotropical Biodiversity]]></source>
<year>2018</year>
<volume>4</volume>
<page-range>55-61</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chippaux]]></surname>
<given-names><![CDATA[JP.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence and mortality due to snakebite in the Americas]]></article-title>
<source><![CDATA[PLoS Negl Trop Dis]]></source>
<year>2017</year>
<volume>11</volume>
<page-range>1-39</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud Pública</collab>
<source><![CDATA[Manejo clínico de pacientes con mordeduras de serpientes venenosas y picaduras de escorpiones]]></source>
<year>2017</year>
<edition>Primera edición</edition>
<page-range>1-113</page-range><publisher-loc><![CDATA[Quito ]]></publisher-loc>
<publisher-name><![CDATA[Dirección Nacional de Prevención y Control y Dirección Nacional de Normatización]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Smalligan]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cole]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Brito]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Laing]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
<name>
<surname><![CDATA[Mertz]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Manock]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Crotaline snake bite in the Ecuadorian Amazon: Randomised double blind comparative trial of three South American polyspecific antivenoms]]></article-title>
<source><![CDATA[Br Med J]]></source>
<year>2004</year>
<volume>329</volume>
<page-range>1-7</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Manock]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Suárez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Graham]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Ávila-Aguero]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Warrell]]></surname>
<given-names><![CDATA[DA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurotoxic envenoming by South American coral snake (Micrurus lemniscatus helleri): Case report from eastern Ecuador and review]]></article-title>
<source><![CDATA[Trans R Soc Trop Med Hyg]]></source>
<year>2008</year>
<volume>102</volume>
<page-range>1127-32</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ochoa-Avilés]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Heredia-Andino]]></surname>
<given-names><![CDATA[OS]]></given-names>
</name>
<name>
<surname><![CDATA[Escandón]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Celorio-Carvajal]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Arias-Peláez]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Zaruma-Torres]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Viperidae snakebites in Ecuador: A review of epidemiological and ecological aspects]]></article-title>
<source><![CDATA[Toxicon X]]></source>
<year>2020</year>
<volume>7</volume>
<page-range>1-8</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Praba-Egge]]></surname>
<given-names><![CDATA[AD]]></given-names>
</name>
<name>
<surname><![CDATA[Cone]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
<name>
<surname><![CDATA[Araim]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Freire]]></surname>
<given-names><![CDATA[IL]]></given-names>
</name>
<name>
<surname><![CDATA[Paida G]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Escalante]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Snakebites in the rainforests of Ecuador]]></article-title>
<source><![CDATA[World J Surg]]></source>
<year>2003</year>
<volume>27</volume>
<page-range>234-40</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kerrigan]]></surname>
<given-names><![CDATA[KR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Venomous snakebite in eastern Ecuador]]></article-title>
<source><![CDATA[Am J Trop Med Hyg]]></source>
<year>1991</year>
<volume>44</volume>
<page-range>93-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<collab>Ministerio de Salud Pública-Subsecretaría de Vigilancia de la Salud Pública</collab>
<source><![CDATA[Efectos tóxicos año 2020]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<collab>Instituto Nacional de Estadística y Censos</collab>
<source><![CDATA[Estadísticas]]></source>
<year>2022</year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Espíndola]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Calles]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ulloa]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<source><![CDATA[Atlas &#8220;Amazonía Ecuatoriana Bajo Presión&#8221;]]></source>
<year>2013</year>
<page-range>1-56</page-range><publisher-loc><![CDATA[Quito ]]></publisher-loc>
<publisher-name><![CDATA[EcoCiencia]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Larrick]]></surname>
<given-names><![CDATA[JW]]></given-names>
</name>
<name>
<surname><![CDATA[Yost]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Kaplan]]></surname>
<given-names><![CDATA[J.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Snake bite among the Waorani indians of Eastern Ecuador]]></article-title>
<source><![CDATA[Trans R Soc Trop Med Hyg]]></source>
<year>1978</year>
<volume>72</volume>
<page-range>542-3</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[González-Andrade]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Chippaux]]></surname>
<given-names><![CDATA[JP.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Snake bite envenomation in Ecuador]]></article-title>
<source><![CDATA[Trans R Soc Trop Med Hyg]]></source>
<year>2010</year>
<volume>104</volume>
<page-range>588-91</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Creagh]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Gámez]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Dueñas]]></surname>
<given-names><![CDATA[O.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características clínico epidemiológicas de los accidentes ofídicos. Ecuador, 2014]]></article-title>
<source><![CDATA[IntraMed Journal]]></source>
<year>2017</year>
<volume>6</volume>
<page-range>7</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Giovannini]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Medicinal plants of the Achuar (Jivaro) of Amazonian Ecuador: Ethnobotanical survey and comparison with other Amazonian pharmacopoeias]]></article-title>
<source><![CDATA[J Ethnopharmacol]]></source>
<year>2015</year>
<volume>164</volume>
<page-range>78-88</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="">
<collab>Gobierno Autónomo Descentralizado de la Provincia de Sucumbíos</collab>
<source><![CDATA[Actualización Plan de Desarrollo y Ordenamiento Territorial, 2015]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="">
<collab>World Health Organization</collab>
<source><![CDATA[International Statistical Classification of Diseases and Related Health Problems, 10th Revision, 2016]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="">
<collab>The Jamovi project</collab>
<source><![CDATA[Jamovi]]></source>
<year>2019</year>
</nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Means]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cabrera]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Amini]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Remote South American snakebite with extensive myonecrosis]]></article-title>
<source><![CDATA[Clin Pract Cases Emerg Med]]></source>
<year>2017</year>
<volume>1</volume>
<page-range>47-9</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Theakston]]></surname>
<given-names><![CDATA[RDG]]></given-names>
</name>
<name>
<surname><![CDATA[Laiug]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
<name>
<surname><![CDATA[Fielding]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Lascano]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Touzet]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Vallejo]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of snake bites by Bothrops species and Lachesis muta in Ecuador: Laboratory screening of candidate antivenoms]]></article-title>
<source><![CDATA[Trans R Soc Trop Med Hyg]]></source>
<year>1995</year>
<volume>89</volume>
<page-range>550-4</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Da Silva]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Colombini]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Moura-Da-Silva]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[De Souza]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
<name>
<surname><![CDATA[Monteiro]]></surname>
<given-names><![CDATA[WM]]></given-names>
</name>
<name>
<surname><![CDATA[Bernarde]]></surname>
<given-names><![CDATA[PS.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Epidemiological and clinical aspects of snakebites in the Upper Juruá River Region, Western Brazilian Amazonia]]></article-title>
<source><![CDATA[Acta Amaz]]></source>
<year>2020</year>
<volume>50</volume>
<page-range>90-9</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Valverde-Muñoz]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Romero-Álvarez]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Measuring the epidemiological uncertainty in snakebite case reports in 2016 Ecuador]]></article-title>
<source><![CDATA[Int J Infect Dis]]></source>
<year>2018</year>
<volume>73</volume>
<page-range>211</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Warrell]]></surname>
<given-names><![CDATA[DA.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Guidelines of management of snake bite]]></article-title>
<source><![CDATA[Lancet]]></source>
<year>2010</year>
<volume>375</volume>
<page-range>77-88</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[FN]]></given-names>
</name>
<name>
<surname><![CDATA[Brito]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Morais]]></surname>
<given-names><![CDATA[ICO de]]></given-names>
</name>
<name>
<surname><![CDATA[Fook]]></surname>
<given-names><![CDATA[SML]]></given-names>
</name>
<name>
<surname><![CDATA[Albuquerque]]></surname>
<given-names><![CDATA[HN.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Accidents caused by Bothrops and Bothropoides in the State of Paraiba: Epidemiological and clinical aspects]]></article-title>
<source><![CDATA[Rev Soc Bras Med Trop]]></source>
<year>2010</year>
<volume>43</volume>
<page-range>662-7</page-range></nlm-citation>
</ref>
<ref id="B28">
<label>28</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Otero-Patiño]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<source><![CDATA[Snake bites in Colombia]]></source>
<year>2014</year>
<page-range>1-42</page-range><publisher-loc><![CDATA[Springer ]]></publisher-loc>
<publisher-name><![CDATA[Dordrecht]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B29">
<label>29</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ortiz-Prado]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Yeager]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Andrade]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Schiavi-Guzmán]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Abedrabbo-Figueroa]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Terán]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Snake antivenom production in Ecuador: Poor implementation, and an unplanned cessation leads to a call for a renaissance]]></article-title>
<source><![CDATA[Toxicon]]></source>
<year>2021</year>
<volume>202</volume>
<page-range>90-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
