Antivenom shortages and emergency preparedness in Vietnam: a silent public health crisis

To the Editor, Vietnam faces a significant burden from snakebite envenoming: data from the Poison Control Center of Bach Mai Hospital in northern Vietnam state that it treats approximately 30 000 cases annually. However, there is still a big data gap regarding snakebite envenoming in this nation.1 Also, as reported in cross-sectional studies that mention the incidence of snakebite, there are 31 cases and one death per 100 000 persons annually.2,3 Of these reports concerning the high incidence of snakebite envenoming in mountainous regions, the highest incidence was 178 cases per 100 000 persons annually.3 As reported above, mountainous, rural and coastal regions have a significant lack of healthcare infrastructure. The deficiencies in healthcare systems in these regions include emergency kits, intensive care facilities, region-specific antivenom storage and clinical knowledge for early diagnosis and management.1,2 Hence, patients must travel long distances using poor transport systems; or they adopt ineffective traditional practices, such as herbal poultices, bloodletting or religious rituals before seeking formal care, and these remain a prevalent first-line response to snakebite in many rural areas, leading to critical delays in treatment. This reliance on traditional healing stems from cultural beliefs, limited health literacy and a lack of trust in public health services, which ultimately originates from restrictions in the public healthcare approach.4 In local health facilities, there are insufficiently qualified human resources in emergency medicine or intensive care. Also, there are still critical shortages of frozen fresh plasma and equipment.