{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T19:28:14Z","timestamp":1791487694997,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011442","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000}}],"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T00:00:00Z","timestamp":1687737600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["16.137.114"],"award-info":[{"award-number":["16.137.114"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Envenoming by <jats:italic>Echis<\/jats:italic> spp. (carpet or saw-scaled vipers) causes haemorrhage and coagulopathy and represents a significant proportion of snakebites in the savannah regions of West Africa. Early diagnosis of envenoming is crucial in the management of these patients and there is limited evidence on the utility of the 20-minute whole blood clotting test (20WBCT) in diagnosing venom-induced consumptive coagulopathy (VICC) following envenoming by <jats:italic>Echis ocellatus<\/jats:italic>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective observational cohort study was conducted at the Kaltungo General Hospital in North-eastern Nigeria from September 2019 to September 2021. Standardised 20WBCTs were conducted by trained hospital staff and citrated plasma samples were collected at numerous timepoints. Prothrombin time (PT) and international normalised ratio (INR) were determined using a semi-automated analyser and INR values were calculated using international sensitivity indices (ISI). The sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and likelihood ratios of the 20WBCT compared to an INR \u2265 1.4 were calculated, alongside 95% confidence intervals.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We enrolled 121 patients into our study, with a median age of 26 (18.0\u201335.0) years and a male predominance (75.2%). The 20WBCT was positive (abnormal) in 101 out of 121 patients at timepoint 0h, of which 95 had an INR \u2265 1.4, giving a sensitivity of 87.2% (95%CI 79.4\u201392.8). Among patients with a negative 20WBCT (normal), six had an INR &lt; 1.4 giving a specificity of 50% (95%CI 21.1\u201378.9). The positive and negative likelihood ratios were 1.7 (95%CI 1.6\u20131.9) and 0.3 (95%CI 0.1\u20130.4) respectively.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The 20WBCT is a simple, cheap, and easily accessible bedside test with a high sensitivity for the detection of patients with venom induced consumptive coagulopathy (VICC) following envenoming by <jats:italic>E<\/jats:italic>. <jats:italic>ocellatus<\/jats:italic>, although false positives do occur. Repeated 20WBCTs can identify patients with new, persistent, and rebound coagulopathy.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011442","type":"journal-article","created":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T17:26:54Z","timestamp":1687800414000},"page":"e0011442","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic characteristics of the 20-minute whole blood clotting test in detecting venom-induced consumptive coagulopathy following carpet viper envenoming"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5687-5285","authenticated-orcid":true,"given":"Frank-Leonel","family":"Tianyi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Hamza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saidu B.","family":"Abubakar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaffer","family":"Al Solaiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Trelfa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadiza L.","family":"Abdullahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garba","family":"Iliyasu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuhu","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suleman A.","family":"Mohammed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas R.","family":"Casewell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David G.","family":"Lalloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ymkje","family":"Stienstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrazaq G.","family":"Habib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,26]]},"reference":[{"key":"pntd.0011442.ref001","author":"World Health Organisation.","year":"2019","journal-title":"Snakebite envenoming: a strategy for prevention and control"},{"key":"pntd.0011442.ref002","first-page":"433","volume-title":"In Handbook of: Clinical Toxicology of Animal Venoms and Poisons","author":"CRC Press","year":"2017"},{"key":"pntd.0011442.ref003","first-page":"181","article-title":"Snake bites and antivenom availability in the urban community of Niamey, Niger.","volume":"95","author":"J-P Chippaux","year":"2002","journal-title":"Bulletin de la Societe de Pathologie Exotique (1990)"},{"key":"pntd.0011442.ref004","first-page":"184","article-title":"Epidemiology of snake envenomations in northern Cameroon.","volume":"95","author":"J-P Chippaux","year":"2002","journal-title":"Bulletin de la Societe de Pathologie Exotique (1990)"},{"key":"pntd.0011442.ref005","first-page":"291","article-title":"Epidemiological aspects of snakebites in Benin.","volume":"98","author":"L Fourn","year":"2005","journal-title":"Bulletin de la Societe de Pathologie Exotique (1990)"},{"key":"pntd.0011442.ref006","first-page":"197","article-title":"The incidence of snakebite in a rural zone of southeastern Senegal.","volume":"98","author":"E Guyavarch","year":"2005","journal-title":"Bulletin de la Societe de Pathologie Exotique (1990)"},{"key":"pntd.0011442.ref007","first-page":"33","article-title":"Poisoning by bites of the saw-scaled or carpet viper (Echis carinatus) in Nigeria.","volume":"46","author":"DA Warrell","year":"1977","journal-title":"The Quarterly journal of medicine"},{"key":"pntd.0011442.ref008","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/j.1365-2141.1976.tb03549.x","article-title":"Disseminated Intravascular Coagulation Caused by the Carpet Viper (Echis carinatus): Trial of Heparin","volume":"33","author":"DA Warrell","year":"1976","journal-title":"British Journal of Haematology"},{"key":"pntd.0011442.ref009","first-page":"367","article-title":"Mad-To\u00efngu\u00e9J, Kerah CH. 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