Geographical distribution and health care disparities of scorpion stings in Brazil

Fan, Hui Wen; Monteiro, Wuelton Marcelo; Scheidt, João Felipe Hermann Costa; Andrade, Luciano de; Ye, J.; Staton, Catherine A.; Gerardo, Charles J.; Vissoci, João Ricardo Nickenig

doi:10.1016/j.toxicon.2020.04.060

Cited by 5 publications

(3 citation statements)

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“…In the Brazilian Amazon region, mortality is also associated with delayed access to care [ 130 ], lower literacy levels and income than in the Southeast region [ 130 ], due to geographical barriers and long distances to reach local health units [ 54 ], the delay in receiving immunotherapy [ 33 , 36 , 54 ] and sometimes the specific antivenom is not available ( Table 4 ) [ 49 ]. Pharmacokinetic studies showed that venom concentrations were maximal at 15 min in the kidney and liver, and at 30 min in serum, lung, heart and spleen, after subcutaneous injection of T. serrulatus venom [ 131 ].…”

Section: Resultsmentioning

confidence: 99%

Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps

Martins¹,

Santos

Procópio

et al. 2021

J. Venom. Anim. Toxins incl. Trop. Dis

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Scorpionism is a relevant medical condition in Brazil. It is responsible for most accidents involving venomous animals in the country, which leads to severe symptoms that can evolve to death. In recent years, an increase of almost 50% in the incidence of scorpionism has been observed in the Northern Region, where the highest severity of envenoming has been notified since the beginning of the 21 st century. This review aims to provide an in-depth assessment of public data and reports on symptoms and epidemiology of envenoming, ecological aspects of scorpions, and characterization of venoms and toxins to access the gaps that need to be filled in the knowledge of the scorpion species of medical importance from the Brazilian Amazon. A systematic search using the string words “Amazon” and “scorpion” was performed on 11 databases. No restriction on date, language or status of the publication was applied. Reports not related to the Brazilian Amazon were excluded. Therefore, 88 studies remained. It is shown that populations of scorpions of medical importance, even of the same species, may present significant toxic variations peculiar to some regions in the Brazilian Amazon, and commercial scorpion antivenoms were not able to shorten the intensity and duration of neurological manifestations in patients stung by T. silvestris, T. apiacas or T. obscurus . It is also highlighted that the toxins responsible for triggering these alterations have not been elucidated yet and this is a fruitful field for the development of more efficient antivenoms. Furthermore, the geographic distribution of scorpions of the genus Tityus in the Brazilian Amazon was revised and updated. The cumulative and detailed information provided in this review may help physicians and scientists interested in scorpionism in the Brazilian Amazon.

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Section: Resultsmentioning

confidence: 99%

Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps

Martins¹,

Santos

Procópio

et al. 2021

J. Venom. Anim. Toxins incl. Trop. Dis

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“…Brazil is considered a model country for epidemiological surveys on snakebite envenoming, according to its high zoological, ecological [ 13 , 26 ], climatic [ 27 , 28 ] and socioeconomic diversity [ 29 , 30 ]. Only between 2011 and 2020, 1.9 million accidents with snakes were recorded in this country, of which at least 1.7 million were caused by unidentified snakes, 17,000 accidents by non-venomous snakes and 235,872 by venomous snakes such as Bothrops spp., the major group of venomous snakes in this country [ 31 – 33 ].…”

Section: Introductionmentioning

confidence: 99%

Who are the most affected by Bothrops snakebite envenoming in Brazil? A Clinical-epidemiological profile study among the regions of the country

da Silva,

de Siqueira Santos,

Lira

et al. 2023

PLoS Negl Trop Dis

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Snakebite envenoming represents an important Neglected Tropical Disease (NTD) that mainly affects tropical and subtropical developing countries according to the World Health Organization (WHO). As a priority issue in the tropics, it is estimated that accidental encounter between snakes and humans is the leading cause of morbidity and mortality among all NTDs in the world. In Brazil, an extremely diverse country with continental dimensions, snakebite envenoming is the second leading cause of reported human envenoming. Treating the disease has been an unprecedented challenge for Brazilian Health Systems for decades. Despite access to Antivenom therapy and distributing it free of charge across the country, Brazil faces numerous issues regarding the notification process and accurate treatment targeting for at-risk populations. Thus, this study aimed to identify the temporal epidemiological dynamics of accidents caused by Bothrops snakes in Brazil, the country’s major group of venomous snakes, based on secondary information from the online database provided by The Brazilian Notifiable Diseases Information System (SINAN). For this purpose, reported Bothrops snakebites between 2012 and 2021 were counted, then the data were analyzed. We looked at the frequency, occurrence, mortality rates, case fatality rate (CFR), age and gender distribution, and the time lapse between the incident and the initiation of Antivenom therapy. The data were also organized considering regional variations of the country. Throughout the studied period, a total of 202,604 cases of envenoming caused by Bothrops spp. were notified, resulting in 766 fatalities. These accidents were found to occur in variable proportions across different regions in Brazil, with notable concentrations observed in the North, Northeast, and Southeast regions. The epidemiological profile of patients varied greatly between the regions, revealing that snake envenoming is much more a social, economic, and ecological problem than a medical one. In conclusion, our study provides an overview of the clinical and epidemiological profile of envenoming by Bothrops snakes in Brazil. Notably, this is the first study to present such information in a country as vast and diverse as Brazil, encompassing a comparative analysis of its regions using SINAN data, that proves to be a very useful national tool to improve the control and management of envenoming.

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“…In some countries, it has tripled from 2013 to 2017. Also, mortality has increased by 50% in the same period (2). Most of these cases occur in the Middle East, India, the African continent, and Latin America, especially in Mexico and Brazil (3).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years

Mousavi,

Rashidi,

Faramarzi

et al. 2023

Trends Med Sci

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Background: Scorpionism is a considerable public health problem worldwide in tropical and subtropical regions. It is one of the major health problems and the leading cause of death in the western and southern parts of Iran. Objectives: This study was performed with the aim of investigating the epidemiological features of scorpion stings in Shoushtar city. Methods: This cross-sectional study was performed on 5479 cases in Shoushtar city, Khuzestan province, Iran, from January 1, 2014 until December 31, 2018. First, the incidence rate of scorpion stings was calculated for the study years; then, the bites frequency distribution chart was drawn by month. The t-test and Fisher exact test were used for data analysis using SPSS 22. Results: The average incidence rate of scorpion stinging during the study period was 579.55 per 100000. There was a gradual decrease in the incidence rate over the study period. The incidence of scorpionism was lower in winter, especially in January and February. The most prone body parts of sting were arms and legs (76%); the stings were more common in men than women and more in urban areas than rural areas. Household women had the highest frequency of stings, so almost 1 of every 3 victims was household women; most stings happened indoors. There was a significant association between gender and location, so it was 13 times more in women than men in an indoor location (P = 0.001, OR = 0.076). Conclusions: Shoushtar is a city with a high incidence rate of scorpion sting in the country, especially in the warm seasons. Most cases of stings occur in Housekeepers and in indoor environments. It seems renovation of residential areas, using chemical controls in roofed areas, and enhancing people's knowledge regarding the advantage of using gloves and boots can be vital in the reduction of sting incidences.

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Geographical distribution and health care disparities of scorpion stings in Brazil

Cited by 5 publications

References 0 publications

Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps

Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps

Who are the most affected by Bothrops snakebite envenoming in Brazil? A Clinical-epidemiological profile study among the regions of the country

Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years

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