Escorpionismo no Extremo Sul da Bahia, 2010-2017: perfil dos casos e fatores associados à gravidade*

Abstract

Objective: to describe the epidemiological profile of scorpionism and to investigate factors associated with case severity in the Far South of Bahia, Brazil. Methods: this was a descriptive study using data on scorpion accidents reported on the Notifiable Health Conditions Information System (SINAN) from 2010 to 2017; odds ratios (OR) were calculated to investigate factors associated with severe cases. Results: 3,055 cases were reported, of which 411 (13.5%) were severe and included 10 deaths; highest incidence occurred in 2017 (1.3 per 1,000 inhabitants); cases predominated in rural areas (62.5%), among males (70.1%), those aged 20-49 years (51%), and Black people (84%); 22.7% of those stung received serotherapy; severe cases were more frequent among children under 15 years old (OR=3.26; 95%CI 2.55;4.74), and people stung in rural areas (OR=1.40; 95%CI 1.10;1.78). Conclusion: scorpionism incidence increased; case severity was associated with younger people and occurrence in rural areas.

Evolution of the occurrence of Tityus serrulatus (LUTZ & MELLO, 1992) in the state of Santa Catarina

“…Envenomation was more prevalent in men than in women (59.8% vs. 40.2%), which was also reported by Lisboa and Bucaretchi 13,25 , while a higher incidence in women was observed by Carmo (54.9% vs. 45.1%) and Taniele-Silva (61.8% vs. 38.2%) 10,11 . Observing the mapping of the residential areas most prone to the occurrence of scorpions, it is clear that all inhabitants of a residence are equally susceptible to stings by scorpions, which is in accordance with our findings, considering that the differences in susceptibility between men and women are not statistically significant 1 .…”

“…The majority of the cases were mild (94.6%), with 4.5% of the cases being moderate and 0.9% severe. Other studies have also reported a higher incidence of mild cases in several regions of Brazil, while severe cases varied from 0.4% to 13.5% [10][11][12][13] . Envenoming with T. serrulatus registered in Santa Catarina did not evolve severely, which can be associated with the lower number of cases with children in this state, since other states show a higher prevalence in children aged 0-12 years old [10][11][12][13][14][15][16] and T. serrulatus is involved in most severe cases and fatal outcomes, especially when the victims are children 17 .…”

“…Other studies have also reported a higher incidence of mild cases in several regions of Brazil, while severe cases varied from 0.4% to 13.5% [10][11][12][13] . Envenoming with T. serrulatus registered in Santa Catarina did not evolve severely, which can be associated with the lower number of cases with children in this state, since other states show a higher prevalence in children aged 0-12 years old [10][11][12][13][14][15][16] and T. serrulatus is involved in most severe cases and fatal outcomes, especially when the victims are children 17 . This was also observed in other studies, which reported a greater volume of envenomation classified as serious among children aged 4-8 years and the occurrence of one pediatric death, which evolved in less than 24 h to acute pulmonary edema and cardiogenic shock 14 .…”

“…This higher number of cases in urban areas seems to be a reality in the epidemiology of scorpionism in Brazil, which was also observed in studies carried out in the countryside of the states of Bahia, Alagoas, Ceará, and in the city of São José do Rio Preto. These studies showed a prevalence of 73-94.7% [10][11][12]14 of the cases in urban areas, although one study performed in the south of Bahia observed a higher incidence in rural areas (62.5%) than in urban areas (32%) 13 .…”

“…These results are similar to those observed in other studies, which showed that most victims had specialized assistance in less than 1 h after the sting 10,14,15 . Lisboa observed a higher incidence in the time elapsed before care from 1 to 3 h after envenomation (39.3%) 13 . Comparing these data with SINAN's statistics 3 , we noticed a constant relationship between time of envenoming × time until health care.…”