Ukąszenie skorpiona – Epidemiologia

Ukąszenie skorpiona
Epidemiologia

Ukąszenia skorpionów stanowią istotny problem zdrowia publicznego, szczególnie w regionach tropikalnych i subtropikalnych, gdzie rocznie dochodzi do ponad 1,2 miliona ukąszeń, z około 3250 zgonami (śmiertelność ~0,27%). Najwyższe wskaźniki zachorowalności obserwuje się w Afryce Północnej i Południowej, Bliskim Wschodzie, południowych Indiach, Meksyku oraz Ameryce Łacińskiej. Przykładowo, w Algierii wskaźnik zachorowalności w rejonie Touggourt wynosi 542/100 000 mieszkańców, a w Iranie w prowincji Khuzestan rejestruje się 12 150 przypadków rocznie. Ukąszenia mają charakter sezonowy, z wyraźnym wzrostem w miesiącach letnich (np. czerwiec w Iranie 16% przypadków, lipiec w innych regionach), a większość zdarzeń ma miejsce nocą (do 60,9% w Iranie). Czynniki ryzyka obejmują przebywanie na obszarach wiejskich, wykonywanie prac rolniczych, niewystarczające warunki sanitarne oraz specyficzne zachowania, takie jak noszenie drewna opałowego czy brak ochrony rąk podczas zbiorów. Ukąszenia dotyczą głównie osób w wieku 10-49 lat, z przewagą mężczyzn (np. 86% w Katarze). Wiele przypadków pozostaje niezgłoszonych, co utrudnia dokładną ocenę epidemiologiczną i planowanie interwencji.

Epidemiologia ukąszeń skorpionów

Ukąszenia skorpionów stanowią poważny problem zdrowia publicznego na całym świecie, zwłaszcza w regionach tropikalnych i subtropikalnych. Według globalnych szacunków, ponad 2,5 miliarda ludzi żyje na obszarach zagrożonych ukąszeniami skorpionów¹. Każdego roku dochodzi do ponad 1,2 miliona ukąszeń skorpionów, co prowadzi do śmierci co najmniej 3250 osób na całym świecie (wskaźnik śmiertelności około 0,27%)¹². Warto zauważyć, że na każdą osobę zabitą przez jadowitego węża, 10 osób ginie z powodu ukąszenia jadowitego skorpiona².

Globalne rozmieszczenie i częstość występowania

Przypadki ukąszeń skorpionów są rejestrowane na całym świecie, ale ich częstość występowania i cechy zatruć różnią się w zależności od regionu³. Szczególnie narażone na ukąszenia skorpionów są regiony pustynne, półpustynne i saharyjskie na całym świecie w pasie szerokości geograficznej 50° zarówno na południe, jak i na północ⁴. Największe wskaźniki zachorowalności odnotowuje się w:

Afryce Saharyjskiej (północnej)
Afryce Sahelskiej
Afryce Południowej
Bliskim i Środkowym Wschodzie
południowych Indiach
Meksyku
południowej Ameryce Łacińskiej
regionie na wschód od Andów⁵

W Meksyku co roku dochodzi do około 1000 zgonów z powodu ukąszeń skorpionów, podczas gdy w Stanach Zjednoczonych w ciągu 11 lat odnotowano tylko 4 zgony². W Brazylii liczba przypadków ukąszeń skorpionów wzrosła z 12 552 w 2000 roku do 69 033 w 2013 roku, a w 2017 roku przekroczyła 120 000 przypadków, co stanowi ponad trzykrotny wzrost w ciągu 10 lat⁶⁷.

Regionalne wskaźniki zachorowalności

Wskaźniki zachorowalności na ukąszenia skorpionów różnią się znacznie w zależności od regionu geograficznego:

W Algierii: średni roczny wskaźnik zachorowalności wyniósł 542 przypadki na 100 000 mieszkańców w rejonie Touggourt⁸
W Iranie: w prowincji Khuzestan rocznie występuje 12 150 przypadków, a w obszarach tropikalnych prowincji Kermanshah wskaźnik zachorowalności wynosił 334,37/100 000 mieszkańców w 2008 r. i 339,07/100 000 w 2009 r.⁹¹⁰
W Arabii Saudyjskiej: badanie pięcioletniego nadzoru wykazało 6465 przypadków ukąszeń skorpionów, a całkowita częstość ukąszeń skorpionów w regionie Hail wynosiła 18,7 na 1000 w okresie 15 miesięcy⁹¹¹
W Brazylii: średnia roczna zachorowalność w stanie Ceará wynosiła 18,57 przypadków/100 000 mieszkańców¹²
W Wenezueli: w gminie Montes w stanie Sucre odnotowano wskaźnik zachorowalności 38,6 przypadków na 10 000 mieszkańców¹³

Trendy sezonowe

Aktywność skorpionów jest silnie zależna od temperatury, co wpływa na sezonowy charakter ukąszeń¹⁴. Występuje wyraźny wzrost liczby ukąszeń skorpionów w miesiącach letnich⁸. W wielu regionach najwyższy wskaźnik ukąszeń skorpionów odnotowuje się w lecie, ze szczytem w lipcu¹⁴. Na przykład:

W Iranie: czerwiec był miesiącem o najwyższej liczbie ukąszeń (16%), a luty najniższej (0,6%)⁹
W Brazylii: w przypadku półkuli południowej, najwięcej ukąszeń skorpionów występuje w miesiącach od października do kwietnia¹⁵
W Erytrei: większość (94,8%) przypadków ukąszeń skorpionów wystąpiła w okresie letnim, przy czym najwyższa liczba ukąszeń skorpionów przypadała na wrzesień i październik¹⁶

Badania wykazały również, że klimat deszczowy może wpływać na częstotliwość incydentów związanych ze skorpionami. Niższe poziomy opadów, szczególnie opady poniżej 30 mm/miesiąc, mogą być związane z mniejszą liczbą ukąszeń skorpionów, podczas gdy opady większe niż 30 mm/miesiąc nie wykazują związku ze wskaźnikiem zachorowalności¹⁵.

Wzorce demograficzne

Ukąszenia skorpionów dotyczą wszystkich grup wiekowych, jednak istnieją pewne wzorce demograficzne:

Wiek: 70% ukąszeń skorpionów dotyczy osób w wieku od 10 do 49 lat⁸. W przypadku badania przeprowadzonego w Arabii Saudyjskiej średni wiek pacjentów wynosił 23 lata⁹. W Katarze najwyższą liczbę przypadków odnotowano w grupie wiekowej 19-39 lat¹⁷.
Płeć: Wiele badań wykazuje przewagę mężczyzn wśród ofiar ukąszeń. Na przykład w Katarze rozkład ukąszeń skorpionów był wyższy wśród mężczyzn niż kobiet, z odsetkiem odpowiednio 86% i 14%¹⁷. W Arabii Saudyjskiej stosunek mężczyzn do kobiet wynosił 1,9⁹.
Narażone grupy: Najbardziej narażone grupy to rolnicy, robotnicy i osoby mieszkające na obszarach wiejskich¹. W wielu krajach ukąszenia skorpionów częściej występują na obszarach wiejskich (59,6-73%)²⁵.

Systemy nadzoru i raportowania

Dokładne statystyki dotyczące zatruć skorpionów nie są dostępne globalnie. Wiele potencjalnie niebezpiecznych skorpionów zamieszkuje kraje słabo rozwinięte lub rozwijające się. W konsekwencji liczne przypadki zatruć pozostają niezgłoszone, a rzeczywista częstość występowania jest nieznana⁹. Istnieje wyraźny niedobór danych epidemiologicznych dotyczących ukąszeń skorpionów, głównie z powodu zmniejszonej ciężkości zatruć skorpionami wśród dorosłych oraz słabej organizacji usług zdrowotnych¹.

Wyzwania związane z nadzorem

Według WHO, prawdziwe obciążenie zatruciem ukąszeniami skorpionów nie jest znane, ponieważ wiele wypadków ma miejsce w wioskach na obszarach tropikalnych i subtropikalnych, gdzie ofiary prawdopodobnie nie szukają pomocy medycznej¹⁸. W Iranie szacuje się, że rzeczywista liczba ukąszeń skorpionów wynosi od 2 do 2,5 razy więcej niż zarejestrowane przypadki¹⁹.

W wielu krajach brakuje odpowiednich systemów nadzoru epidemiologicznego nad ukąszeniami skorpionów. Szacunki globalnych zatruć skorpionami są ograniczone do kilku krajów, które posiadają wiarygodny system nadzoru epidemiologicznego⁴. Na przykład w Meksyku zidentyfikowano kilka niespójności w danych dotyczących nowych przypadków zatruć ukąszeniami skorpionów w latach 2017-2019²⁰.

Skuteczne systemy nadzoru

Niektóre kraje wdrożyły skuteczne systemy nadzoru nad ukąszeniami skorpionów:

W Algierii od 1986 roku funkcjonuje krajowy program kontroli ukąszeń skorpionów²¹.
W Brazylii ukąszenia skorpionów są obowiązkowo rejestrowane przez brazylijski System Informacji o Chorobach Podlegających Zgłoszeniu (SINAN), który jest głównym systemem badawczym do gromadzenia i analizy danych krajowych dotyczących ukąszeń skorpionów w Brazylii²².
W Arabii Saudyjskiej nadzór nad przypadkami ukąszeń skorpionów w regionie Hail rozpoczął się w maju 1994 roku¹¹.
W Iranie badanie wykorzystujące metodę skalowania sieciowego wykazało, że nie ma istotnej różnicy między danymi zarejestrowanymi w uniwersyteckim departamencie zdrowia a metodą skalowania sieciowego, co wskazuje na wysoką skuteczność systemu opieki zdrowotnej w wykrywaniu i identyfikacji przypadków¹⁹.

Znaczenie nadzoru

Skuteczny nadzór jest kluczowy dla planowania i alokacji zasobów. Nacisk powinien być położony na programy kontroli zwierząt jadowitych, które powinny obejmować system nadzoru ułatwiający lepsze raportowanie przypadków ukąszeń. Dane generowane poprzez ulepszony system należy wykorzystać do planowania wymagań dotyczących antytoksyny i prazosyny w zależności od regionu i placówki. Środki te pomogą zapobiec śmierci poprzez zapewnienie dostępu do terminowego leczenia²³.

W ostatnich dziesięcioleciach, mimo postępów w naukach medycznych, zatrucia skorpionami były ignorowane z dwóch głównych powodów: nieznanej częstości występowania i dużej liczby ofiar o niskich dochodach. W tym aspekcie, w celu zmniejszenia częstości występowania ukąszeń skorpionów i ich powikłań, IV Międzynarodowa Konferencja na temat Ukąszeń Wężów i Ukąszeń Skorpionów w Dakarze podkreśliła potrzebę opracowania lepszych systemów rejestracji i raportowania oraz optymalizacji gromadzenia danych o urazach spowodowanych przez skorpiony⁵.

Czynniki ryzyka i okoliczności ukąszeń

Badania epidemiologiczne sugerują, że większość ukąszeń skorpionów występuje w domu, głównie w nocy ze względu na nocne zwyczaje pajęczaków²⁴. Skorpiony są nocnymi zwierzętami, które typowo żyją na pustyniach, w górach, jaskiniach i pod skałami. Atakują, gdy są niepokojone²⁵.

Środowiskowe czynniki ryzyka

Ukąszenia skorpionów stanowią problem głównie na obszarach wiejskich ze względu na specyficzne siedlisko skorpionów, które żyją w szczelinach mieszkań, podziemnych norach, pod kłodami lub gruzem, w plewach ryżowych, na polach trzciny cukrowej, w plantacjach kokosów i bananów²³. Czynniki ryzyka związane ze środowiskiem obejmują:

Przebywanie na obszarze wiejskim
Niewystarczające czyszczenie gospodarstwa domowego
Dachy wykonane z tymczasowych płyt lub liści palmowych
Trzymanie kaczek w domu
Praca w rolnictwie
Wysokość 300 metrów nad poziomem morza²⁴

Behawioralne czynniki ryzyka

Badanie przeprowadzone w wysoce zmarginalizowanej gminie w Guerrero w Meksyku wykazało, że czynniki związane z ukąszeniami skorpionów obejmowały:

Noszenie drewna opałowego (OR 2,1; CI95% 1,40-3,09)
Trzymanie kur hodowanych na wolnym wybiegu wokół domu (OR 1,9; CI95% 1,19-2,85)
Zamieszkiwanie obszaru wiejskiego (OR 1,7; CI95% 1,04-2,78)
Bycie mężczyzną (OR 1,6; CI95% 1,18-2,28)
Pomoc w pracach domowych (OR 1,6; CI95% 1,04-2,40)²⁶
Nieużywanie rękawic podczas zbiorów kukurydzy²⁴

Czas i lokalizacja ukąszeń

Cechy epidemiologiczne ukąszeń skorpionów wykazują tendencję do większej liczby przypadków na obszarach wiejskich (59,6-73%), przy czym większość ukąszeń występuje w miesiącach letnich między godziną 18:00 a 24:00 (49%) oraz drugi szczyt od 6:00 do 12:00 (30%). Oba te szczyty zbiegają się z maksymalną aktywnością człowieka i maksymalną aktywnością skorpiona². Nocne zatrucia są nieco częstsze niż dzienne, ponieważ skorpion jest bardziej aktywny w nocy².

W prowincji Khuzestan w Iranie zatrucia nocne występowały w 60,9% przypadków, 39,3% ukąszeń miało miejsce w ręce, a 37,3% ukąszeń w stopy⁹. Wysoką częstość wypadków wewnątrz mieszkań można tłumaczyć znacznym narażeniem na wypadki związane ze skorpionami w środowisku domowym podczas wykonywania czynności domowych²⁷.

Region	Najczęstsze miejsce ukąszenia	Sezonowy szczyt	Pora dnia	Wskaźnik zachorowalności
Iran (Khuzestan)	Ręce (39,3%), stopy (37,3%)	Czerwiec (16%)	Nocne (60,9%)	12,150 przypadków rocznie
Algeria (Touggourt)	Nogi i ramiona	Lato	Wieczór	542/100,000 mieszkańców
Turcja (południowo-wschodnia)	Kończyny dolne (75), kończyny górne (72)	Lato	Wieczór	–
Iran (Shoushtar)	Ramiona i nogi (77,5%)	Ciepłe pory roku	–	579,55/100,000
Brazylia (Zachodnia Amazonia)	–	Miesiące deszczowe	–	Korelacja z poziomem rzek

Modele prognostyczne i analiza danych

W ostatnich latach badacze rozwinęli zaawansowane modele statystyczne do prognozowania dziennej liczby ukąszeń skorpionów, co ma istotne znaczenie dla planowania zasobów medycznych i działań profilaktycznych²⁸²⁹.

Modele prognostyczne

Badanie przeprowadzone w Algierii wykazało, że negatywny dwumianowy model progowy (negative binomial hurdle model) był odpowiedni do prognozowania dziennych ukąszeń w zależności od temperatury i wilgotności względnej, a dopasowane dane były zgodne z rzeczywistymi danymi²⁸. Modele regresji liczebnościowej wykorzystujące dzienną liczbę ukąszeń skorpionów jako zmienną zależną oraz temperaturę, wilgotność względną i ich trendy jako zmienne niezależne wykazały, że negatywny dwumianowy model progowy zapewniał odpowiednie dopasowanie³⁰.

W innym badaniu przeprowadzonym w południowym Iranie zidentyfikowano, że mieszany sezonowy proces ARMA (1, 1) (0, 1)12 był odpowiedni do wykorzystania w danych dotyczących ukąszeń skorpionów. Dwa istotne czynniki wpływające na wynik przypadków ukąszeń skorpionów to miesięczne średnie temperatury i wilgotności względnej²⁹.

Zastosowania analizy danych

Modele SARIMA (Seasonal AutoRegressive Integrated Moving Average) są przydatne do monitorowania przypadków ukąszeń skorpionów i zapewniają oszacowanie zmienności, której można się spodziewać w przyszłych przypadkach ukąszeń skorpionów³¹. Takie modele mogą być wykorzystywane do oszacowania ilości antytoksyny, która musi być dostępna dla ofiar w ciągu roku³².

Analiza epidemiologiczna wykazała przewagę mężczyzn, zgodnie z podobnym wzorcem na poziomie krajowym w wielu badaniach. Przedział czasu do pierwszej opieki medycznej był krótszy niż 3 godziny po ukąszeniu ofiary w przypadku większości ofiar, co świadczy o tym, że populacja stała się świadoma potrzeby szukania opieki zaraz po ukąszeniu, a kampanie świadomości publicznej mające na celu uniknięcie samego ukąszenia nie powiodły się³⁰.

Obciążenie systemów opieki zdrowotnej

Ukąszenia skorpionów stanowią znaczne obciążenie dla wydatków na opiekę zdrowotną w wielu krajach²⁸. W niektórych regionach ukąszenia skorpionów są częstym problemem, z którym spotyka się personel medyczny³³.

Wykorzystanie opieki zdrowotnej

W Algierii roczna liczba ukąszeń skorpionów waha się wokół 50 000 przypadków²⁸. W Iranie Komitet ds. Chorób Niezakaźnych (INCDC) podaje, że rocznie rejestruje się około pięćdziesięciu tysięcy przypadków ukąszeń skorpionów³⁴.

W Państwie Palestyńskim jedyną dostępną antytoksyną była przeciwsurowica przeciw jadowi skorpiona IHS produkowana w Indiach przez VINS BIO Products³³. W Turcji 76 pacjentów leczono antytoksyną, a 28 pacjentów otrzymało alfa-bloker³⁵.

Obciążenie ekonomiczne

W Meksyku ukąszenia skorpionów zajmują 15. miejsce wśród najważniejszych schorzeń w kraju według Sekretariatu Zdrowia (SSA)³⁶. W programie Programa Especfico de Accin para la Prevencin y Control de la Intoxicacin por Picadura de Alacrn 2013-2018 (Specjalny Program Działania na rzecz Zapobiegania i Kontroli Zatrucia Ukąszeniem Skorpiona) SSA określiła cztery ważne cele dotyczące zarządzania i kontroli tego stanu medycznego³⁶.

Dane wskazują, że w przypadku krajów rozwijających się często odnotowuje się wyższy odsetek wypadków związanych z zatruciem skorpionami i związaną z tym śmiertelnością w porównaniu z krajami rozwiniętymi z powodu niższych struktur społeczno-ekonomicznych i nieodpowiednio wyposażonych placówek zdrowotnych¹⁸.

Działania profilaktyczne i kontrolne

Kontrola i profilaktyka mają zasadnicze znaczenie dla zmniejszenia częstości występowania przypadków, a ich skuteczność zależy od multidyscyplinarnych działań, które obejmują publiczne agencje zdrowotne, zarządzanie środowiskiem i społeczność, mających na celu uniknięcie korzystnych warunków osiedlania się dla rozprzestrzeniania się skorpionów³⁷.

Wyniki badań sugerują, że odnowienie obszarów mieszkalnych, stosowanie kontroli chemicznej na obszarach zadaszonych oraz zwiększenie wiedzy ludzi na temat korzyści z używania rękawic i butów może być kluczowe dla zmniejszenia częstości występowania ukąszeń³⁸.

Edukacyjne programy profilaktyczne skierowane do grup ryzyka mają kluczowe znaczenie dla zapobiegania wypadkom związanym z ukąszeniami skorpionów i śmiertelności w obszarach o ograniczonych zasobach³⁹. Ze względu na stosunkowo wysoką częstość występowania ukąszeń skorpionów w obszarach tropikalnych zaleca się edukację mieszkańców za pośrednictwem środków masowego przekazu na temat zapobiegania ukąszeniom i stosowania wstępnego leczenia⁴⁰.

Wyzwania i przyszłe kierunki

Mimo postępów w zarządzaniu ukąszeniami skorpionów, wciąż istnieje wiele wyzwań, które wymagają uwagi⁴¹. Cele ustalone w planie działania Meksyku na rok 2013 są dalekie od realizacji. Szacunki nowych przypadków zatruć ukąszeniami skorpionów zostały przekroczone o prawie 70 000 przypadków. Częstość występowania pozostała stała w stanach uznanych za priorytetowe, co wskazuje, że polityka kontroli zatruć ukąszeniami skorpionów jest niespójna⁴².

Przyszłe kierunki

Przyszłe działania powinny koncentrować się na:

Poprawie nadzoru epidemiologicznego nad zatruciem ukąszeniami skorpionów i dostępu do informacji w celu publicznego ujawnienia wszystkich zgłoszonych danych²⁰
Wzmocnieniu programów szkolenia personelu medycznego w zakresie rozpoznawania i leczenia ukąszeń skorpionów⁴³
Zwiększeniu nakładów finansowych na produkcję i dystrybucję antytoksyn⁴³
Opracowaniu skuteczniejszych strategii profilaktycznych, które uwzględniają czynniki ryzyka specyficzne dla każdego obszaru³⁶
Wdrożeniu systemów modelowania prognozującego do lepszego planowania reagowania na sezonowe wzrosty liczby przypadków²⁸

Potrzeby badawcze

Istnieje potrzeba dalszych badań w następujących obszarach:

Skuteczność konkretnych interwencji zapobiegawczych w różnych kontekstach społeczno-kulturowych²⁶
Doskonalenie metod identyfikacji i taksonomii skorpionów w regionach endemicznych⁴⁴
Opracowanie skuteczniejszych protokołów leczenia ukierunkowanych na konkretne gatunki skorpionów⁴⁵
Badanie długoterminowych konsekwencji zdrowotnych przeżycia ukąszenia skorpiona⁴⁶

Wysiłki te pomogą lepiej zrozumieć epidemiologiczne aspekty ukąszeń skorpionów i opracować bardziej skuteczne strategie zapobiegania i leczenia³⁹.

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#1 An update on epidemiology and management practices of Scorpion envenomation in India
https://pmc.ncbi.nlm.nih.gov/articles/PMC9731072/
Scorpion envenomation is a life-threatening condition, particularly for children. Therefore, it is essential for primary care health providers to suspect, identify, and manage this condition early to prevent death and minimize morbidity. […] To identify the key epidemiological characteristics of scorpion envenomation and update the primary care health workers regarding the latest management practices of scorpion envenomation. […] Worldwide, over 2.5 billion people are living at risk of scorpion stings. Every year, over 1.2 million are stung by scorpions leading to the death of at least 3,250 people globally. The most vulnerable group includes farmers, laborers, and those living in rural areas. […] There is a paucity of epidemiological data on scorpion stings mainly because of the reduced severity of scorpion envenomations among adults and poor organization of health services.
#2 Scorpion Envenomation: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/168230-overview
Scorpion stings are a major public health problem in many underdeveloped tropical and subtropical countries, especially Sahelian Africa, South India, the Middle East, Mexico, and South Latin America. The estimated annual number of scorpion stings is 1.2 million leading to 3250 deaths (0.27%). For every person killed by a venomous snake, 10 are killed by a venomous scorpion. In Mexico, 1000 deaths from scorpion stings occur per year. In the United States, only 4 deaths in 11 years have occurred as a result of scorpion stings. Furthermore, scorpions can be found outside their normal range of distribution, that is when they crawl into luggage, boxes, containers, or shoes and are unwittingly transported home via human travelers. […] Approximately 16,000 stings have been reported, with the majority being from the nonlethal scorpions. Only 1 of 30 scorpion species found in the United States is dangerous to humans. The neurotoxin-bearing and potentially lethal scorpion species in the United States is the Arizona bark scorpion in the genus Centruroides. Less than 1% of stings from Centruroides are lethal to adults; however, 25% of children younger than 5 years who are stung die if not treated. The epidemiological features of a patient who has been envenomed show a disposition for rural areas (59.6-73%), with most of the stings occurring in the summer months between 6:00 pm and 12:00 am (49%) and a second peak from 6:00 am to 12:00 pm (30%). Both of these peaks coincide maximum human activity with maximum scorpion activity. In addition, nocturnal envenomations are slightly more common than diurnal, as the scorpion is more active at night. Furthermore, the larger the scorpion population, the larger the incidence rate. Because the offending scorpion is recovered for identification in only 30% of the cases, local knowledge of the type of scorpion populating the area is useful.
#3 (PDF) Scorpion sting epidemiology in Montes municipality of the State of Sucre, Venezuela: geographic distribution
https://www.academia.edu/22720960/Scorpion_sting_epidemiology_in_Montes_municipality_of_the_State_of_Sucre_Venezuela_geographic_distribution
Scorpion sting is a neglected public health problem, despite a global estimate of 1.2 million scorpion stings and some 3,250 deaths annually. […] Scorpion stings are registered worldwide, but the incidence and the features of the envenomations vary depending on the region. […] The large number of scorpion stings worldwide is concerning and reaffirms the need for new prevention measures and policies to reduce the incidence, prevalence, morbidity, and mortality rates from these poisonous arachnids. […] Scorpion envenomation in Cear is an environmental public health problem that needs to be monitored and controlled throughout the year. […] More than half a million people have been stung by scorpions in the Northeast of the country alone since 2007, and about 70% of reported cases occurred in just three of the nine states.
#4 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://www.e-epih.org/journal/view.php?number=1117
This study was conducted to provide better insights into the demographic and epidemiological characteristics of scorpion envenomation in an endemic area in Algeria and to identify the model that best predicted daily scorpion sting counts. […] Scorpion stings currently constitute a public health concern in many arid, semi-arid, or Saharan regions throughout the world within the stripe of 50 latitude, both south and north. Approximately 2 billion people are estimated to live in areas at risk for scorpion stings. Each year, an estimated 1.2 million people are victims of scorpion stings worldwide. Second only to snake-bites in terms of venomous animal-related human fatalities, scorpions are responsible for an estimated 3,000 deaths each year. However, these estimates are limited to the few countries that have a reliable system for scorpion sting epidemiological surveillance.
#5 The epidemiology of scorpion stings in tropical areas of Kermanshah province, Iran, during 2008 and 2009 | Journal of Venomous Animals and Toxins including Tropical Diseases | Full Text
https://jvat.biomedcentral.com/articles/10.1186/s40409-015-0045-4
In a related review study by Chippaux and Goyffon, seven areas were identified as more at risk, including Saharan Africa (north), Sahelian Africa, South Africa, the Near and Middle-East, southern India, Mexico and southern Latin America, and the region east of the Andes, where the total at risk population is 2.3 billion. […] In recent decades, although medical science has advanced, scorpion envenomation has been ignored for two main reasons, namely its unknown prevalence and a high number of low-income victims. […] In this aspect, in order to reduce the incidence of scorpion stings and its complications, the 4th International Conference on Snakebites and Scorpion Stings in Dakar, stressed the need to develop better recording and reporting systems, and optimize the gathering of data on scorpion injuries.
#6 SciELO Brazil – EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL
https://www.scielo.br/j/rimtsp/a/whrwK7cbMQdQpwM5ZBH5KXg/?lang=en
This report is a retrospective study of the epidemiology of scorpion sting cases recorded from 2007 to 2013 in the State of Cear, Northeastern Brazil. […] Scorpion envenomation is a worldwide public health problem, particularly in tropical and subtropical countries, due to its high incidence and the capacity of some species to induce severe clinical manifestations, being at times fatal. […] In Brazil, the number of cases of scorpion sting increased from 12,552 in 2000 to 69,033 in 2013. […] The Brazilian Northeast has had the highest incidence of cases, followed by the Southeast, Midwest, North, and South. […] Despite its medical importance, the epidemiological profile of scorpion envenomation cases in Northeastern Brazil has not been conclusively determined. […] A total of 11,134 scorpion sting cases were recorded by the Health Department of Cear from January/2007 to December/2013.
#7 (PDF) Scorpion sting epidemiology in Montes municipality of the State of Sucre, Venezuela: geographic distribution
https://www.academia.edu/22720960/Scorpion_sting_epidemiology_in_Montes_municipality_of_the_State_of_Sucre_Venezuela_geographic_distribution
The number of Brazilian scorpion stings has surpassed 120,000 cases in 2017, and has been maintained above this number ever since, representing a more than 3-fold increase in 10 years, which was higher than the number of cases for most of the neglected tropical diseases in the country. […] The incidence of scorpion stings was 334.37/100,000 inhabitants in 2008 and 339.07/100000 in 2009. […] In Mexico, scorpion sting envenomation (SSE) is a significant public health issue that has engaged the attention of health authorities for more than a century. […] The number of scorpion stings has remained stable since the mid-2000s. […] Scorpion stings are a major public health problem in Brazil, with an increasing number of registered cases every year.
#8 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://pmc.ncbi.nlm.nih.gov/articles/PMC7871152/
This study was conducted to provide better insights into the demographic and epidemiological characteristics of scorpion envenomation in an endemic area in Algeria and to identify the model that best predicted daily scorpion sting counts. […] Daily sting data from January 1, 2013 to August 31, 2016 were extracted from questionnaires designed to elicit information on scorpion stings from the two emergency medical service providers in Touggourt, Algeria. Count regression models were applied to the daily sting data. […] A total of 4,712 scorpion sting cases were documented, of which 70% occurred in people aged between 10 years and 49 years. […] The mean annual incidence rate was 542 cases per 100,000 inhabitants. […] The incidence of scorpion stings increased sharply in the summer. […] Scorpion stings currently constitute a public health concern in many arid, semi-arid, or Saharan regions throughout the world within the stripe of 50 latitude, both south and north. Approximately 2 billion people are estimated to live in areas at risk for scorpion stings. Each year, an estimated 1.2 million people are victims of scorpion stings worldwide.
#9 Scorpion Envenomation: Background, Pathophysiology, Etiology
https://emedicine.medscape.com/article/168230-overview
Accurate statistics on scorpion envenomation are not available. Many potentially dangerous scorpions inhabit the underdeveloped or developing world. Consequently, numerous envenomations go unreported, and true incidence is unknown. However, it has been estimated that there are 1.2 million scorpion stings per year. A 5-year surveillance study in Saudi Arabia found 6465 scorpion sting cases with a mean patient age of 23 years, a male-to-female ratio of 1.9, and a higher incidence of stings in the months of May through October. In Khuzestan province of Iran, 12,150 annual cases occurred, with nocturnal envenomations occurring 60.9% of the time, 39.3% stings occurring on the hands, and 37.3% stings occurring on the feet. June was the highest month for stings, at 16%, and February, the lowest at 0.6%.
#10 The epidemiology of scorpion stings in tropical areas of Kermanshah province, Iran, during 2008 and 2009 | Journal of Venomous Animals and Toxins including Tropical Diseases | Full Text
https://jvat.biomedcentral.com/articles/10.1186/s40409-015-0045-4
The incidence of scorpion stings was estimated at 334.37 and 339.07 individuals per 100,000 in 2008 and 2009, respectively, in the current study. […] The present results showed no significant difference among the age groups in terms of clinical symptoms. […] The present findings indicate that more than 57 % of scorpion stings occurred in roofed buildings. […] Following up the status of patients who were dispatched to other centers was impossible in the present work, so this was accepted as a non-control constraint. […] The results of our study indicate a high incidence of scorpion stings in the tropical areas of Kermanshah.
#11 WHO EMRO | Scorpion sting syndrome: epidemiology, clinical presentation and management of 2240 cases | Volume 3, issue 1 | EMHJ volume 3, 1997
https://www.emro.who.int/emhj-volume-3-1997/volume-3-issue-1/article10.html
Surveillance of cases of scorpion stings in Hail region, Saudi Arabia, started in May 1994. […] The incidence of scorpion stings was studied in relation to country of origin, sex and age. […] A total of 2241 cases of stings were reported during the 15-month period between June 1994 and the end of August 1995. […] The total incidence of scorpion stings was 18.7 per 1000 for the 15-month period. […] The incidence of scorpion stings detected is clearly higher than that reported from the Libyan Arab Jamahiriya. […] In conclusion, the high incidence of scorpion stings in Hail region suggests the necessity of preventive programmes for decreasing the incidence.
#12 SciELO Brazil – EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL
https://www.scielo.br/j/rimtsp/a/whrwK7cbMQdQpwM5ZBH5KXg/?lang=en
There was a gradual increase in the number of cases during the investigated period: from 681 cases in 2007 to 3,401 cases in 2013. […] The average incidence rates per 100,000 inhabitants were 8.05; 5.50; 8.54; 13.03; 28.20; 28.16; and 40.24 cases from 2007 to 2013, respectively. […] Five deaths were recorded, and the average lethality rate was of 0.07%. […] There was a significant increase of scorpion sting cases in Cear from 2007 to 2013. […] The annual average incidence was of 18.57 cases/100,000 inhabitants, which is in agreement with that reported by the Brazilian Health Ministry. […] Scorpion sting cases were distributed over 168 out of the 184 municipalities of Cear, indicating the presence of scorpions in most regions of the State. […] The highest number of cases in urban areas (87.25%) is in accordance with ALVES et al., (2007), who reported a high incidence of cases in Fortaleza, mainly in the urban area.
#13 Scorpion sting epidemiology in Montes municipality of the State of Sucre, Venezuela: geographic distribution Translated title: EpidemiologÃa do escorpionismo no MunicÃpio Montes, Estado Sucre, Venezuela: distribuiÃ§Ã£o geogrÃ¡fica â ScienceOpen
https://www.scienceopen.com/document?vid=212ec3d4-2e42-4531-ad36-b2e739d67eba
Scorpion stings were surveyed in the Montes Municipality of the State of Sucre, Venezuela, aiming to extend the information on these poisonous accidents by characterizing their geographic distribution. From 1980 to 1990, 184 cases of scorpion stings were recorded with an incidence rate of 38.6 cases per 10,000 inhabitants. The locality of San Fernando presented the highest incidence (68.3(0)/000) of poisonous accidents. The highest percentages of severe cases were recorded in the towns of Arenas (27%), San Lorenzo (21%), and Cocollar (19%), which are located at the foot of the Turimiquire Mountains. This region is a dispersion area of scorpions of the Tityus genus. Our results show that this region of the State of Sucre is endemic for scorpion stings which are an important public health problem.
#14 Scorpion sting in children | PPT
https://www.slideshare.net/slideshow/scorpion-sting-in-children/249616381
The scorpion activity is highly temperature dependent. Therefore, the highest rate of scorpion stings are reported in summer with the highest proportion of stings occurring in July. […] Scorpions from this family can cause severe envenomation which is sometimes lethal to the elderly and children. […] Clinical manifestations of scorpion sting depend on Age, gender, weight, Health of the victim(comorbidities) Time of envenomation (season of sting ), Nature of the incident, Number of stings, Site of envenomation. The duration to progress to systemic symptoms ranges from 5 minutes to 4 hours after the sting. The symptoms generally persist for 10-48 hours. […] In children, the following factors were associated with a higher mortality: metabolic acidosis, tachypnea, myocarditis, pulmonary edema, encephalopathy, and priapism. The mode of death is usually via respiratory failure secondary to anaphylaxis, bronchoconstriction, bronchorrhea, pharyngeal secretions, and/or diaphragmatic paralysis, even though venom-induced multiorgan failure may play a large role.
#15 Scorpion sting – Wikipedia
https://en.wikipedia.org/wiki/Scorpion_sting
Scorpions are nocturnal arachnids that have shown a seasonal pattern that is also related to climate. Specifically in Central America, scorpion attacks are mostly seen during the hot months of the year, noting that in Argentina this occurs in the months of October to April. Additionally, a rainy climate may also change the frequency of scorpion incidents. Lower levels of rainfall, specifically precipitation below 30 mm/month, can be associated with fewer scorpion stings, whereas rainfall greater than 30 mm/month shows no relationship to incident rate. […] In Central America, most scorpion stings are mildly toxic to humans. However, Panama has reported an incidence of 52 cases per 100,000 people in 2007. Between 1998 and 2006, 28 people have died as result of scorpion stings. In Panama, the taxa of scorpions responsible for these deaths belong to the genus Tityus. This scorpion species is also found in parts of northern South America.
#16 Clinical features and outcomes of scorpion sting in western lowland of Eritrea: a prospective descriptive study | medRxiv
https://www.medrxiv.org/content/10.1101/2024.01.02.24300701v1.full
Scorpion envenomation is a public health problem that results in a life-threatening medical emergency in tropical and subtropical regions. […] This study aimed to determine clinical features and outcome of patients hospitalized due to scorpion stings at the Tesseney Community Hospital. […] A prospective, descriptive cross-sectional study conducted from 1st June 2019 to 31st May 2020 on patients hospitalized due to scorpion stings at the Tesseney Community Hospital. […] 165 scorpion sting patients were admitted during the study period. […] Majority (94.8%) of scorpion sting cases occurred during the summer period with highest scorpion stings counts belonging to September and October. […] The fatality rate (4.8%) was largely associated age groups less than 15 years old with (p = 0.006, OR: 2.845; 95% CI: 0.656-12.343).
#17 Epidemiology of scorpion sting and snakebite cases in Qatar 2018â2022: A primary care-based study | QScience.com
https://www.qscience.com/content/journals/10.5339/jemtac.2023.26
Background: Envenomation caused by snakebites and scorpion stings is a neglected disease responsible for significant morbidity and mortality. W Qatar, little information is available on the epidemiological aspects of snakebites and scorpion stings. This study describes the demographic and epidemiological characteristics of patients treated for scorpion stings or snakebites at Qatars Primary Health Care Corporation (PHCC). […] A retrospective data analysis was applied to investigate the number of scorpion stings and snakebites reported at the PHCC health centers between January 1, 2018, and December 31, 2022. […] 581 scorpion stings and 21 cases of snakebites were reported between January 1, 2018, and December 31, 2022. […] The distribution of scorpion stings was higher among males than females, with rates of 86% and 14%, respectively, and the highest number of cases occurred in the age group of 19-39 years.
#18 Clinical features and outcomes of scorpion sting in western lowland of Eritrea: a prospective descriptive study | medRxiv
https://www.medrxiv.org/content/10.1101/2024.01.02.24300701v1.full
Accurate global statistical evidence on scorpion stings are not readily available, but the literature indicates that all settings are usually affected by this medical threat. […] In 2018, WHO reported that the true scorpion sting envenomation burden is not known because many accidents occur in villages within tropical and subtropical countries where victims likely do not seek medical attention. […] It is estimated that 1.23 million scorpion stings occur per year with roughly 3250 deaths per year. […] Developing countries are often reported with higher scorpion envenomation accidents and related mortality compared to developed countries due to lower socioeconomic structures and inadequately equipped health facilities. […] This study may be a tool to identify at-risk population groups and build measures to prevent scorpion stings within the western lowlands of Eritrea.
#19 Epidemiological Investigation and Sensitivity of Surveillance System in the Report of Scorpion Stings in the Southeast of Iran using the Network Scale-up Method
https://openpublichealthjournal.com/VOLUME/16/ELOCATOR/e187494452305261/FULLTEXT/
Scorpion sting is one of the most common health problems in tropical and subtropical regions, including the south of Iran. The information regarding it can be useful to correctly measure the incidence and mortality rates due to scorpion stings and to identify the high-risk groups to allocate the necessary resources and facilities in case of scorpion stings. […] Scorpion stings in Iran are the most important type of venomous stings, with an average of 50,000 cases and about 20 deaths per year. However, it is estimated that the actual number of these stings is 2 to 2.5 times this number. […] The results of the network scale-up estimation method showed that there is no significant difference between the data recorded in the university health department and the network scale-up method. Therefore, it reduces the possibility of undercounting based on the recorded data and shows that the health system is fully alert in discovering and identifying cases.
#20 Document | Latin American Journal of Clinical Sciences and Medical Tecnology
https://www.lajclinsci.com/vD-1-21
Scorpion sting envenomation (SSE) is a public health problem in Mexico. In 2013, Secretara de Salud established an objective to reduce the incidence of SSE by 36% through strategies focused on medical care, biological control of scorpions and prevention. […] The main objective of this study was to evaluate the policy for the control of SSE in Mexico through an analysis of new cases and incidences to identify future challenges in the control of this acute medical condition. […] Several inconsistencies were identified in the data regarding new cases of SSE in 2017-2019, with Durango, Puebla, Jalisco, and Guerrero being the states with the highest incidences. […] The results indicate that SSE has increased throughout the country. […] It is essential to improve both the epidemiological surveillance of SSE and the access to information to publicly disclose all data reported.
#21 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://www.e-epih.org/journal/view.php?number=1117
Scorpion envenomations represent a major public health issue, with nearly three-quarters of the country’s population at risk for scorpion stings. A national program for scorpion sting control has been operated since 1986. The yearly number of scorpion stings fluctuates around 50,000 cases, and scorpion stings therefore pose a heavy burden on the nation’s health care expenditures. […] The mean annual incidence rate was 542 cases per 100,000 inhabitants. […] The fitted count regression models showed that a negative binomial hurdle model was appropriate for forecasting daily stings in terms of temperature and relative humidity, and the fitted data agreed considerably with the actual data. […] The epidemiological analysis showed a male predominance, following a similar pattern to that at the national level.
#22 Severity of Scorpion Stings in the Western Brazilian Amazon: A Case-Control Study | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0128819
Scorpion stings are a major public health problem in Brazil, with an increasing number of registered cases every year. […] This paper describes the epidemiology and identifies factors associated with severity of scorpions stings in the state of Amazonas, in the Western Brazilian Amazon. […] This study was aimed at describing the epidemiology and identifying risk factors for severity of scorpions stings in the Brazilian state of Amazonas (western area), still with very low deforestation, based on reliable surveillance records. […] Scorpion stings are compulsorily recorded by the Brazilian Notifiable Diseases Information System [Sistema de Informao de Agravos de Notificao (SINAN)] based on data from forms used in the investigation and follow-up of cases of animal envenomings. SINAN is the main survey system for collection and analysis of national data on scorpion stings in Brazil.
#23 An update on epidemiology and management practices of Scorpion envenomation in India
https://pmc.ncbi.nlm.nih.gov/articles/PMC9731072/
Most scorpion stings are a problem in rural areas due to the peculiar habitat of scorpions that live in the crevices of dwellings, underground burrows, under logs or debris, paddy husk, sugarcane fields, coconut and banana plantations. […] Scorpion envenomation should be treated as an emergency with early therapy with prazosin followed by a timely referral. […] Capacity building of primary care providers, educating the general population, a robust referral system, and better reporting of animal bites or stings through a surveillance system should be the key components of the government program for controlling animal bites and stings. […] Emphasis should be given to venomous animal control programs, which should include a surveillance system to facilitate better reporting of bites or stings cases. Data generated through improved should be used to plan the region-wise and facility-wise requirements of antivenom and prazosin. These measures will help prevent death by ensuring access to timely treatment.
#24 Occurrence of scorpion sting and associated factors in a highly marginalized municipality in Guerrero, Mexico: A cross-sectional study | PLOS Neglected Tropical Diseases
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011271
Scorpion sting is a neglected public health problem, despite a global estimate of 1.2 million scorpion stings and some 3,250 deaths annually. […] Epidemiological studies suggest a majority of scorpion stings occur at home, mainly at night due to the nocturnal habits of arachnids. […] Risk factors for scorpion sting include being in a rural area; insufficient household cleaning; roofing constructed from temporary sheeting or palm leaves; keeping ducks in the home; agricultural work; an altitude of 300 meters above sea level; being male; being mixed race (as opposed to indigenous); and, not using gloves when harvesting corn. […] The present study aimed to estimate scorpion stings occurrence and identify the associated risk factors. […] The overall period prevalence of scorpion stings in the year prior to the study was 4.4% (218/4985), 5.4% in men (126/2320), and 3.5% in women (92/2665), p0.01.
#25 Scorpion sting – Wikipedia
https://en.wikipedia.org/wiki/Scorpion_sting
Scorpion stings account for approximately 3,000 deaths a year worldwide. […] The Brazilian yellow scorpion (Tityus serrulatus) is one species known for being especially dangerous, being responsible for most scorpion sting fatalities in South America. […] Scorpions are nocturnal animals that typically live in deserts, mountains, caves, and under rocks. It is when they are disturbed that they attack. Scorpions that possess the ability to inject toxic venom with their sting belong to the family Buthidae. The Middle East and North Africa are home to the deadliest scorpions, belonging to the genera Buthus, Leiurus, Androctonus, and Hottentotta. In South America, the deadliest scorpion belongs to genus Tityus. In India and Mexico, the deadliest scorpions involved in scorpionism are Mesobuthus and Centruroides, respectively.
#26 Occurrence of scorpion sting and associated factors in a highly marginalized municipality in Guerrero, Mexico: A cross-sectional study | PLOS Neglected Tropical Diseases
https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0011271
Factors associated with scorpion sting were carrying firewood (OR 2.1; CI95%acl 1.403.09), keeping free-range hens around of the home (OR 1.9; CI95%acl 1.192.85), residing in a rural area (OR 1.7; CI95%acl 1.042.78), being male (OR 1.6; CI95%acl 1.182.28), and helping with housework (OR 1.6; CI95%acl 1.042.40). […] This study confirms scorpion bites are a public health problem in these marginalized communities in Guerrero State, with risk factors related to living conditions and the work process at home and in the fields. […] The findings have relevance for populations with similar characteristics to the study area. […] Strengthening programs for the prevention and control of scorpion stings, via the implementation of low-cost actions at the household, agricultural, and community levels, is necessary to reduce both the number of scorpion stings and their consequences.
#27 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://www.e-epih.org/journal/view.php?number=1117
The most prone body parts to stings were found to be the legs and arms. […] The high frequency of accidents inside the dwelling may reflect significant exposure to scorpion accidents in home environment while carrying out domestic activities. […] The high incidence in summer has been observed in various regions affected by scorpionism. […] The fitted count regression models using the daily scorpion sting count as the dependent variable, and T, RH, and trends therein as independent variables showed that the NBH model yielded adequate fit.
#28 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://pmc.ncbi.nlm.nih.gov/articles/PMC7871152/
Scorpion envenomations represent a major public health issue, with nearly three-quarters of the country’s population at risk for scorpion stings. […] The yearly number of scorpion stings fluctuates around 50,000 cases, and scorpion stings therefore pose a heavy burden on the nation’s health care expenditures. […] Several epidemiological surveys have been conducted in regions affected by scorpionism. […] The fitted count regression models showed that a negative binomial hurdle model was appropriate for forecasting daily stings in terms of temperature and relative humidity, and the fitted data agreed considerably with the actual data. […] The study showed that daily scorpion sting data provided meaningful insights; and the negative binomial Hurdle model was preferable for predicting daily scorpion sting counts.
#29 Predictive determinants of scorpion stings in a tropical zone of south Iran: use of mixed seasonal autoregressive moving average model | Journal of Venomous Animals and Toxins including Tropical Diseases | Full Text
https://jvat.biomedcentral.com/articles/10.1186/s40409-017-0129-4
The activity of scorpions increased from January to the end of May. After that, there is a decrease in sting cases to the end of the year (December). […] The present collected data indicated that scorpion sting cases presented a similar structure during the study period of 51 months. Therefore, the use of a time series model was a suitable approach to characterize the monthly trend of data. […] The mixed seasonal ARMA (1, 1) (0, 1)12 process was suitable to use in scorpion stings data from south Iran. […] The two significant factors affect the outcome of scorpion sting cases are monthly averages of temperature and relative humidity.
#30 Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts in Touggourt, Algeria
https://www.e-kjs.org/journal/view.php?number=1117
Scorpion envenomations represent a major public health issue, with nearly three-quarters of the country’s population at risk for scorpion stings. A national program for scorpion sting control has been operated since 1986. The yearly number of scorpion stings fluctuates around 50,000 cases, and scorpion stings therefore pose a heavy burden on the nation’s health care expenditures. […] The fitted count regression models showed that a negative binomial hurdle model was appropriate for forecasting daily stings in terms of temperature and relative humidity, and the fitted data agreed considerably with the actual data. […] The epidemiological analysis showed a male predominance, following a similar pattern to that at the national level. […] The time interval until first medical care was less than 3 hours after the victim for most victims, revealing that the population has become aware of the need to seek care right after the sting and that public awareness campaigns to avoid the sting itself have failed. […] The fitted count regression models using the daily scorpion sting count as the dependent variable, and temperature, relative humidity, and trends therein as independent variables showed that the negative binomial hurdle model yielded adequate fit.
#31 Epidemiology and Health
https://new.e-chnr.org/articles/search_result.php?term_type=keywords&term=Scorpion%20stings
The epidemiological analysis revealed that scorpion stings were reported continuously throughout the year, with peaks in the summer months. […] The majority of cases (95.9%) were classified as mild envenomations. […] This model was used to predict scorpion sting cases for the year 2013, and the fitted data showed considerable agreement with the actual data. […] SARIMA models are useful for monitoring scorpion sting cases, and provide an estimate of the variability to be expected in future scorpion sting cases.
#32 Predictive determinants of scorpion stings in a tropical zone of south Iran: use of mixed seasonal autoregressive moving average model | Journal of Venomous Animals and Toxins including Tropical Diseases | Full Text
https://jvat.biomedcentral.com/articles/10.1186/s40409-017-0129-4
The present study aims to describe demographic and epidemiologic features of patients affected by scorpion envenomation in Haji-Abad, south Iran; analyze the trends of scorpion stings during 51 months, from May 2012 to July 2016, and look for peaks and troughs during this time period; observe what climatic factors are associated with the activity of scorpions in tropical areas of south Iran; and estimate the amount of antivenom that must be available for victims per year by predicting the number of scorpion stings using mixed seasonal ARMA and multiple regression models. […] The incidence of scorpion sting cases was 13 per 1000 people during the 51 months of the study period. […] The highest number of scorpion stings was registered in 2014, with 253 cases and the lowest was in 2015, with 173 cases.
#33 WHO EMRO | Epidemiology of scorpion stings in the West Bank, occupied Palestinian territory | Volume 29 issue 12 | EMHJ volume 29 2023
https://www.emro.who.int/emhj-volume-29-2023/volume-29-issue-12/epidemiology-of-scorpion-stings-in-the-west-bank-occupied-palestinian-territory.html
Our data reveal a high incidence of scorpion stings in the districts served by the 4 participating hospitals, with an average of 26.32 cases per 100 000 inhabitants per year over an 8-year period. […] Scorpion stings appear to be a common problem in the State of Palestine. […] Although substantial numbers of scorpion stings were recorded during the study, the symptoms recorded were mostly consistent with a Class II classification: minor manifestations (non-life-threatening). […] In the State of Palestine, the only antivenom available was Scorpion Venom Antiserum IHS manufactured in India by VINS BIO Products. […] Scorpion stings are a problem faced frequently by medical staff in the State of Palestine, especially in areas like Jericho District.
#34 Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years
https://brieflands.com/articles/jai-133418
According to the Iranian Non-Communicable Diseases Committee (INCDC), about fifty thousand cases of scorpion stings are recorded annually. […] The epidemiological study on scorpion stings revealed that Khouzestan province has the highest prevalence of stings in the country. […] The results of the present study indicated that despite the high incidence rate during the investigated period, and an overall increase in the country, there was a decrease from 2014 to 2018. […] The highest incidence rate was in 2015, which can be attributed to the Shoushtar river flood and residents’ homelessness in 2015. […] The present study’s findings indicated that the most prone body parts to sting were arms and legs (77.50%), and the least frequent were the head and neck (3%).
#35 Epidemiology of scorpion envenomation in the Southeast of Turkey
https://www.clinmedkaz.org/article/epidemiology-of-scorpion-envenomation-in-the-southeast-of-turkey-9262
The aim of this study was to report the epidemiological features of scorpion envenomation in the southeast of Turkey. […] In this study, records of 312 patients admitted to emergency department between 2018-2019 due to scorpion sting were retrospectively analyzed. […] The mean age of the patients included in the study was 35.4 22.7 years. […] Of the patients included, 106 were female and 89 were male. […] When the sting sites were examined, it was seen that 3 of them were stung from head and neck, 45 of them were trunk, 72 of them were upper extremity and 75 of them were stung from lower extremity part. […] 76 patients were treated with antivenom and 28 patients received alpha blocker. […] Only 2 deaths was recorded (1%). […] Conscious intervention to be applied in scorpion stings, which is still an important health problem for our country, needs to be informed of our people and information of health personnel should be updated.
#36 Document | Latin American Journal of Clinical Sciences and Medical Tecnology
http://www.lajclinsci.com/vD-1-21
According to Secretara de Salud (SSA [Ministry of Health]), Scorpion sting envenomation [SSE] is a health problem of notable importance in Mexico, and ranks 15th among the most relevant conditions in the country. In Programa Especfico de Accin para la Prevencin y Control de la Intoxicacin por Picadura de Alacrn 2013-2018 (Specific Action Program for the Prevention and Control of Scorpion Sting Envenomation), SSA identified four important aims for the management and control of this medical condition: To improve epidemiological information systems in the states to include updates regarding scorpion stings and the most affected regions. To formulate prevention strategies that consider the risk factors for each specific area of the country. To ameliorate housing conditions in priority areas. To reverse the annual increase in cases and maintaining the downward trend in deaths from SSE.
#37 SciELO Brazil – EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL EPIDEMIOLOGY OF SCORPION ENVENOMATION IN THE STATE OF CEARÃ, NORTHEASTERN BRAZIL
https://www.scielo.br/j/rimtsp/a/whrwK7cbMQdQpwM5ZBH5KXg/?lang=en
Control and prevention are essential to reduce the incidence of cases, and their effectiveness depends on multidisciplinary actions that involve health public agencies, environmental management, and the community with the aim of avoiding favorable settling conditions for the proliferation of scorpions. […] Most cases were classified as mild (93.77%), while few cases were classified as moderate (3.28%) or severe (0.15%). […] The predominance of cases progressing to cure (95.86%) is also in accordance to epidemiological studies performed in other Brazilian regions. […] Scorpion envenomation in Cear is an environmental public health problem that needs to be monitored and controlled throughout the year.
#38 Epidemiology of Scorpion Sting in Southwestern Iran Over Five Years
https://brieflands.com/articles/jai-133418
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. […] This study was performed with the aim of investigating the epidemiological features of scorpion stings in Shoushtar city. […] 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. […] Shoushtar is a city with a high incidence rate of scorpion sting in the country, especially in the warm seasons. […] 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.
#39 Clinical features and outcomes of scorpion sting in western lowland of Eritrea: a prospective descriptive study | medRxiv
https://www.medrxiv.org/content/10.1101/2024.01.02.24300701v1.full
The western lowlands of Eritrea have shown to be a conducive area for scorpions with a recent surge of scorpion stings cases within the region, inciting the need for this study. […] Our study found children experienced more severe envenoming symptoms with related mortality compared to adults. […] The unusual high level of class III symptoms is likely a consequence of the villager mindset toward arachnid stings, thus most cases had immediate effects around the sting site with mild, rarely fatal, systemic involvement. […] Preventive educational programs targeting at-risk groups are instrumental to prevent scorpion sting accidents and fatalities in resource-limited areas.
#40 The epidemiology of scorpion stings in tropical areas of Kermanshah province, Iran, during 2008 and 2009 | Journal of Venomous Animals and Toxins including Tropical Diseases | Full Text
https://jvat.biomedcentral.com/articles/10.1186/s40409-015-0045-4
Scorpion stings are an acute health problem in tropical regions. Awareness of this problem is fundamental for establishing preventive interventions, thus prompting the present study to determine the scorpion-sting incidence in tropical areas of Kermanshah province during 2008 and 2009. […] The incidence of scorpion stings was 334.37/100,000 inhabitants in 2008 and 339.07/100000 in 2009. […] Due to the relatively high incidence of scorpion stings in tropical areas of Kermanshah, it is recommended that the inhabitants be educated through the mass media about how to prevent the stings and apply preliminary treatment. […] There are no available accurate statistics on scorpion stings worldwide, but the literature indicates that all settings usually affected by this problem, as well as geographical characteristics and health facilities, affect outcomes, which are serious in some regions.
#41 Document | Latin American Journal of Clinical Sciences and Medical Tecnology
https://www.lajclinsci.com/vD-1-21
The goal of reducing the SSE incidence in Mxico is far from being met. […] The goals established in Plan Especfico de Accin 2013 are far from being met. […] The incidence has remained constant in the states considered priorities, which indicates that the policy for the control of SSE is disjointed. […] The decrease in mortality has had a double effect (i.e., results are successful) but diverts attention from the lack of strategies focused on prevention.
#42 Document | Latin American Journal of Clinical Sciences and Medical Tecnology
http://www.lajclinsci.com/vD-1-21
The results of this research show that this goal was far from being met. In 2017, there were 69,767 more SSE cases than estimated, and in 2018, there were 94,494 more SSE cases than estimated. Thus, the governments strategy for reducing mortality has had a double effect. On the one hand, positive results (decreased mortality) justified the monetary investment in fabotherapics, but on the other, focusing on mortality detracts from the importance of morbidity and, therefore, diverts attention from the failure and abandonment of prevention policies, such as improving housing in areas with higher risk.
#43 Epidemiology of scorpion sting and snakebite cases in Qatar 2018â2022: A primary care-based study | QScience.com
https://www.qscience.com/content/journals/10.5339/jemtac.2023.26
Among the total cases, Bangladeshi and Qatari were the most affected, with a rate of 41% and 14%, respectively. […] The western region had the highest incidence of scorpion stings, at 7.47 per 10,000 persons. […] According to this research, the western region had the highest occurrence of scorpion stings cases, primarily among Bangladeshis and Qataris, particularly in the age group of 19-49 years. […] This study also found similar patterns in snakebite cases. Consequently, this study emphasizes the need for increased investment in antivenom and the training of healthcare professionals to address scorpion stings effectively.
#44 Document | Latin American Journal of Clinical Sciences and Medical Tecnology
http://www.lajclinsci.com/vD-1-21
The high incidence of endemic scorpions has been acknowledged not only in epidemiological research; scorpion distribution studies have gained relevance in the last decade in environmental protection and taxonomy. Mexico accounts for 12% of scorpion species worldwide. Anyhow, the total number of scorpion species is not definitive. […] Unlike envenomation caused by snakebites, SSE has drawn the attention of Mexican health authorities on such a way that they developed Norma Oficial Mexicana (Official Mexican Standard) NOM-033-SSA2-2011 for the surveillance, prevention, and control of scorpion sting envenomation. […] For this purpose, it is relevant to analyze the official data regarding new cases of SSE and incidences reported by SSA from 2017 to 2019. […] Information regarding new SSE cases was obtained from Boletn Epidemiolgico del Sistema Nacional de Vigilancia Epidemiolgica from SSA. It provides weekly reports of SSE cases, which are classified in the non-communicable diseases section, specifically with the code CIE-10 REV. T.63.2, X22. SSE data for the 52 weeks for 2017, 2018, and 2019 were collected.
#45
https://journals.lww.com/jphp/fulltext/2024/05020/analyzing_the_relationship_between_acute.12.aspx
Every year, 1.5 million envenomations in places where scorpions are common cause 2600 fatalities for an estimated 2.5 million people living there. […] Numerous studies have also shown evidence of acute pancreatitis brought on by scorpion stings; one such study focused on the Yellow Scorpion Leiurus quinquestriatus and found that 93% of patients experienced emesis and stomach pain after being stung by this type of scorpion. […] Another study carried out in Trinidad found that pancreatitis was most frequently induced by scorpion stings, with the species Tityus trinitatis accounting for the majority of cases. […] The intricate connection between scorpion venom and acute pancreatitis unveils the underlying mechanisms, associated risks, and therapeutic considerations. However, there is a lack of new research and specific treatment plans for certain scorpion species. More research is needed to refine therapeutic interventions and enhance our understanding of this complex relationship, ultimately improving public health strategies and alleviating the burden on affected populations globally.
#46
https://www.jcdr.net/article_fulltext.asp?id=535
An incidental finding of priapism was noted in 27.02% of the patients. The point to be noted was that it was present in 100% of the cases in the age group of less than 5 years in male children and in 40 % of the cases in the age group of 5-15 years in males. There was no incidence of priapism in males above 15 years. […] In the pre-prazosin era (1961-1983), 25-30% fatality due to pulmonary oedema was reported in scorpion victims from Western India. Ever since the use of prazosin (1984 onwards) started, the mortality in these victims reduced to less than 1%. In the present study, 90.54% cases recovered fully and mortality was seen in 9.46% of the cases.