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Snakebites and scorpion stings in the Brazilian Amazon: identifying research priorities for a largely neglected problem.

Hui Wen F, Monteiro WM, Moura da Silva AM, Tambourgi DV, Mendonça da Silva I, Sampaio VS, dos Santos MC, Sachett J, Ferreira LC, Kalil J, Lacerda M - PLoS Negl Trop Dis (2015)

View Article: PubMed Central - PubMed

Affiliation: Instituto Butantan, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil.

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Five types of snake AVs are currently available: Bothrops AV (main one), Crotalus AV, Bothrops-Crotalus AV, Bothrops-Lachesis AV, and Micrurus AV... Scorpion stings in the Amazon are mostly caused by Tityus obscurus, especially in the state of Pará, which can result in serious and fatal accidents... A verbal autopsy study from the state of Acre found that 10% of tappers and 14% of Amerindians were stung by scorpions at least once in their lifetime... It is difficult for riverine and indigenous populations to reach health centers for treatment of venomous animal injuries... As a result, the number of cases detected officially is probably much lower than the real number... There is an urgent need to ensure availability of effective AVs and to improve their manufacture regulation... However, the possible interspecific venom variation associated with the geographical distribution of snakes may affect the effectiveness of therapeutic AVs against the Amazon Bothrops venom... Efficacy of Brazilian AVs against venom from some Amazon Bothrops species has been investigated... Experimental studies should indicate the need for inclusion of new venoms, the new product needs to be validated by clinical and epidemiological data; Perform stability studies of liquid AVs considering the Amazonian environmental conditions... Although clinical research related to venomous animal injuries has increased, most publications are based on case reports and lack methodological rigor... Moreover, outcome definitions, such as severity ranking criteria, were empirically established, making the results even less generalizable... There are no accurate predictive factors for side effects occurrence and preventing them is not always possible, even with the use of premedication containing corticosteroids and/or antihistamines... Existing studies do not include controls for the intervening variables and samples are of insufficient size, limiting the validity of the results... Recommendations:Establish partnerships for capture of Lachesis snakes and transport to vivariums of laboratories producing AVs; Guide Lachesis reproduction in captivity, which should be led by professionals familiar with their conditions both in nature and supportive maintenance environment; Follow shared Standard Operating Procedures (SOPs) for the collections of venomous animals in order to facilitate exchange of information.

No MeSH data available.


Related in: MedlinePlus

Spatial distribution of snakebites and scorpion stings in the Brazilian Amazon in 2013.Maps were created using incidence per 100,000 inhabitants. A) Snakebites are largely distributed in the Amazonian states, with several counties presenting incidences higher than 100 cases per 100,000 inhabitants, especially in Northern Roraima, Eastern Pará, and Amapá, and in unevenly distributed municipalities across all states. B) Large scorpion sting hot spots are observed in the Western Pará state and Southeastern Amazonas. Several other counties present incidences higher than 100 cases per 100,000 inhabitants in the states of Mato Grosso, Tocantins, and Maranhão.
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pntd.0003701.g001: Spatial distribution of snakebites and scorpion stings in the Brazilian Amazon in 2013.Maps were created using incidence per 100,000 inhabitants. A) Snakebites are largely distributed in the Amazonian states, with several counties presenting incidences higher than 100 cases per 100,000 inhabitants, especially in Northern Roraima, Eastern Pará, and Amapá, and in unevenly distributed municipalities across all states. B) Large scorpion sting hot spots are observed in the Western Pará state and Southeastern Amazonas. Several other counties present incidences higher than 100 cases per 100,000 inhabitants in the states of Mato Grosso, Tocantins, and Maranhão.

Mentions: In 2013, 27,181 and 78,091 cases of snakebites and scorpion stings were reported by the Brazilian Ministry of Health, respectively [4]. The highest incidence was in the North region (52.6 cases/100,000 inhabitants) followed by the Midwest (16.4/100,000). These values, expected to be higher in remote areas of the Brazilian Amazon [5], may be underestimated due to considerable underreporting. Fig 1 presents the spatial distribution of snakebites and scorpion stings in the Brazilian Amazon.


Snakebites and scorpion stings in the Brazilian Amazon: identifying research priorities for a largely neglected problem.

Hui Wen F, Monteiro WM, Moura da Silva AM, Tambourgi DV, Mendonça da Silva I, Sampaio VS, dos Santos MC, Sachett J, Ferreira LC, Kalil J, Lacerda M - PLoS Negl Trop Dis (2015)

Spatial distribution of snakebites and scorpion stings in the Brazilian Amazon in 2013.Maps were created using incidence per 100,000 inhabitants. A) Snakebites are largely distributed in the Amazonian states, with several counties presenting incidences higher than 100 cases per 100,000 inhabitants, especially in Northern Roraima, Eastern Pará, and Amapá, and in unevenly distributed municipalities across all states. B) Large scorpion sting hot spots are observed in the Western Pará state and Southeastern Amazonas. Several other counties present incidences higher than 100 cases per 100,000 inhabitants in the states of Mato Grosso, Tocantins, and Maranhão.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440781&req=5

pntd.0003701.g001: Spatial distribution of snakebites and scorpion stings in the Brazilian Amazon in 2013.Maps were created using incidence per 100,000 inhabitants. A) Snakebites are largely distributed in the Amazonian states, with several counties presenting incidences higher than 100 cases per 100,000 inhabitants, especially in Northern Roraima, Eastern Pará, and Amapá, and in unevenly distributed municipalities across all states. B) Large scorpion sting hot spots are observed in the Western Pará state and Southeastern Amazonas. Several other counties present incidences higher than 100 cases per 100,000 inhabitants in the states of Mato Grosso, Tocantins, and Maranhão.
Mentions: In 2013, 27,181 and 78,091 cases of snakebites and scorpion stings were reported by the Brazilian Ministry of Health, respectively [4]. The highest incidence was in the North region (52.6 cases/100,000 inhabitants) followed by the Midwest (16.4/100,000). These values, expected to be higher in remote areas of the Brazilian Amazon [5], may be underestimated due to considerable underreporting. Fig 1 presents the spatial distribution of snakebites and scorpion stings in the Brazilian Amazon.

View Article: PubMed Central - PubMed

Affiliation: Instituto Butantan, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Five types of snake AVs are currently available: Bothrops AV (main one), Crotalus AV, Bothrops-Crotalus AV, Bothrops-Lachesis AV, and Micrurus AV... Scorpion stings in the Amazon are mostly caused by Tityus obscurus, especially in the state of Pará, which can result in serious and fatal accidents... A verbal autopsy study from the state of Acre found that 10% of tappers and 14% of Amerindians were stung by scorpions at least once in their lifetime... It is difficult for riverine and indigenous populations to reach health centers for treatment of venomous animal injuries... As a result, the number of cases detected officially is probably much lower than the real number... There is an urgent need to ensure availability of effective AVs and to improve their manufacture regulation... However, the possible interspecific venom variation associated with the geographical distribution of snakes may affect the effectiveness of therapeutic AVs against the Amazon Bothrops venom... Efficacy of Brazilian AVs against venom from some Amazon Bothrops species has been investigated... Experimental studies should indicate the need for inclusion of new venoms, the new product needs to be validated by clinical and epidemiological data; Perform stability studies of liquid AVs considering the Amazonian environmental conditions... Although clinical research related to venomous animal injuries has increased, most publications are based on case reports and lack methodological rigor... Moreover, outcome definitions, such as severity ranking criteria, were empirically established, making the results even less generalizable... There are no accurate predictive factors for side effects occurrence and preventing them is not always possible, even with the use of premedication containing corticosteroids and/or antihistamines... Existing studies do not include controls for the intervening variables and samples are of insufficient size, limiting the validity of the results... Recommendations:Establish partnerships for capture of Lachesis snakes and transport to vivariums of laboratories producing AVs; Guide Lachesis reproduction in captivity, which should be led by professionals familiar with their conditions both in nature and supportive maintenance environment; Follow shared Standard Operating Procedures (SOPs) for the collections of venomous animals in order to facilitate exchange of information.

No MeSH data available.


Related in: MedlinePlus