Spatial distribution of snakebites in the State of Ceará, Brazil (2008-2018)

Abstract

Snakebites represent an important, though neglected, public health problem especially in the Northeast of Brazil. There is still a large number of underreported cases, the collection of epidemiological data is deficient, and the ecological and epidemiological knowledge of this envenomation remains limited due to the lack of updated regional and local information. This study describes the epidemiological profile of snakebites recorded by the Notifiable Diseases Information System from 2008 to 2018 in the state of Ceará. The data were organized according to the municipalities of the health macro-regions, considering the variables: sex, snake, gravity and deaths. A total of 8,233 cases was found, with an annual incidence of 8.6/100,000 inhabitants, and a higher prevalence of accidents caused by Bothrops snakes (64%), in men (87.4%) in the Sobral region (25.5%). However, the highest incidence rate was found in the Sertão Central (299.7/100,000). Most cases were considered mild (62%), but the mortality rate was 0.07/100,000 and the case-fatality rate was 0.8%. Among the most affected municipalities, cities like Tauá (1.3%), Sobral (8.1%) and Fortaleza (8.5%) are concerning, considering that the case-fatality rates were above the national average (1%). Snakebites in Ceará follow a pattern similar to that of other states in the Northeast, with a high frequency of incidents where the causative snake is not identified (16%). Considering the gravity of snakebites, studies that evaluate the anthropic and environmental influence in the distribution of cases may help to define priority risk areas, to improve health surveillance and patient care.