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Severity of Scorpion Stings in the Western Brazilian Amazon: A Case-Control Study.

Queiroz AM, Sampaio VS, Mendonça I, Fé NF, Sachett J, Ferreira LC, Feitosa E, Wen FH, Lacerda M, Monteiro W - PLoS ONE (2015)

Bottom Line: The overall lethality rate was 0.3%.Lethality rate among children ≤10 years was 1.3%.Thus, the mapping of scorpions fauna in different Amazon localities is essential and must be accompanied by the characterization of the main biological activities of the venoms.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.

ABSTRACT

Background: Scorpion stings are a major public health problem in Brazil, with an increasing number of registered cases every year. Affecting mostly vulnerable populations, the phenomenon is not well described and is considered a neglected disease. In Brazil, the use of anti-venom formulations is provided free of charge. The associate scorpion sting case is subject to compulsory reporting. This paper describes the epidemiology and identifies factors associated with severity of scorpions stings in the state of Amazonas, in the Western Brazilian Amazon.

Methodology/principal findings: This study included all cases of scorpion stings in the state of Amazonas reported to the Brazilian Diseases Surveillance System from January 1, 2007 to December 31, 2014. A case-control study was conducted to identify factors associated with scorpions sting severity. A total of 2,120 cases were reported during this period. The mean incidence rate in the Amazonas was 7.6 per 100,000 inhabitants/year. Scorpion stings showed a large spatial distribution in the state and represent a potential occupational health problem for rural populations. There was a positive correlation between the absolute number of cases and the altimetric river levels in the Central (p<0.001; Rs = 0.479 linear) and Southwest (p = 0.032; linear Rs = 0.261) regions of the state. Cases were mostly classified as mild (68.6%), followed by moderate (26.8%), and severe (4.6%). The overall lethality rate was 0.3%. Lethality rate among children ≤10 years was 1.3%. Age <10 years [OR = 2.58 (95%CI = 1.47-4.55; p = 0.001)], stings occurring in the rural area [OR = 1.97 (95%CI = 1.18-3.29; p = 0.033) and in the South region of the state [OR = 1.85 (95%CI = 1.17-2.93; p = 0.008)] were independently associated with the risk of developing severity.

Conclusions/significance: Scorpion stings show an extensive distribution in the Western Brazilian Amazon threatening especially rural populations, children ≤10 in particular. Thus, the mapping of scorpions fauna in different Amazon localities is essential and must be accompanied by the characterization of the main biological activities of the venoms. Urban and farming planning, in parallel with awareness of workers at risk for scorpion stings on the need for personal protective equipment use should be considered as public policies for preventing scorpionism.

No MeSH data available.


Related in: MedlinePlus

Flow chart of cases and control selection.The selection of cases and controls groups was based on the Brazilian Ministry of Health classification. All severe stings were included as cases, and three mild and moderate stings were in the control group for each case.
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pone.0128819.g005: Flow chart of cases and control selection.The selection of cases and controls groups was based on the Brazilian Ministry of Health classification. All severe stings were included as cases, and three mild and moderate stings were in the control group for each case.

Mentions: For 94 cases of severe scorpion stings during the study period, 1,953 controls were selected among mild and moderate cases (Fig 5). Table 2 summarizes the results of the univariate and multivariate logistic regression evaluating factors associated with scorpion stings severity. Age <10 years [OR = 2.58 (95%CI = 1.47–4.55; p = 0.001)], stings occurring in the rural area [OR = 1.97 (95%CI = 1.18–3.29; p = 0.033) and in the South region of the state [OR = 1.85 (95%CI = 1.17–2.93; p = 0.008)] were independently associated with the risk of developing severity.


Severity of Scorpion Stings in the Western Brazilian Amazon: A Case-Control Study.

Queiroz AM, Sampaio VS, Mendonça I, Fé NF, Sachett J, Ferreira LC, Feitosa E, Wen FH, Lacerda M, Monteiro W - PLoS ONE (2015)

Flow chart of cases and control selection.The selection of cases and controls groups was based on the Brazilian Ministry of Health classification. All severe stings were included as cases, and three mild and moderate stings were in the control group for each case.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4465172&req=5

pone.0128819.g005: Flow chart of cases and control selection.The selection of cases and controls groups was based on the Brazilian Ministry of Health classification. All severe stings were included as cases, and three mild and moderate stings were in the control group for each case.
Mentions: For 94 cases of severe scorpion stings during the study period, 1,953 controls were selected among mild and moderate cases (Fig 5). Table 2 summarizes the results of the univariate and multivariate logistic regression evaluating factors associated with scorpion stings severity. Age <10 years [OR = 2.58 (95%CI = 1.47–4.55; p = 0.001)], stings occurring in the rural area [OR = 1.97 (95%CI = 1.18–3.29; p = 0.033) and in the South region of the state [OR = 1.85 (95%CI = 1.17–2.93; p = 0.008)] were independently associated with the risk of developing severity.

Bottom Line: The overall lethality rate was 0.3%.Lethality rate among children ≤10 years was 1.3%.Thus, the mapping of scorpions fauna in different Amazon localities is essential and must be accompanied by the characterization of the main biological activities of the venoms.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Ensino e Pesquisa, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, Manaus, Brazil; Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.

ABSTRACT

Background: Scorpion stings are a major public health problem in Brazil, with an increasing number of registered cases every year. Affecting mostly vulnerable populations, the phenomenon is not well described and is considered a neglected disease. In Brazil, the use of anti-venom formulations is provided free of charge. The associate scorpion sting case is subject to compulsory reporting. This paper describes the epidemiology and identifies factors associated with severity of scorpions stings in the state of Amazonas, in the Western Brazilian Amazon.

Methodology/principal findings: This study included all cases of scorpion stings in the state of Amazonas reported to the Brazilian Diseases Surveillance System from January 1, 2007 to December 31, 2014. A case-control study was conducted to identify factors associated with scorpions sting severity. A total of 2,120 cases were reported during this period. The mean incidence rate in the Amazonas was 7.6 per 100,000 inhabitants/year. Scorpion stings showed a large spatial distribution in the state and represent a potential occupational health problem for rural populations. There was a positive correlation between the absolute number of cases and the altimetric river levels in the Central (p<0.001; Rs = 0.479 linear) and Southwest (p = 0.032; linear Rs = 0.261) regions of the state. Cases were mostly classified as mild (68.6%), followed by moderate (26.8%), and severe (4.6%). The overall lethality rate was 0.3%. Lethality rate among children ≤10 years was 1.3%. Age <10 years [OR = 2.58 (95%CI = 1.47-4.55; p = 0.001)], stings occurring in the rural area [OR = 1.97 (95%CI = 1.18-3.29; p = 0.033) and in the South region of the state [OR = 1.85 (95%CI = 1.17-2.93; p = 0.008)] were independently associated with the risk of developing severity.

Conclusions/significance: Scorpion stings show an extensive distribution in the Western Brazilian Amazon threatening especially rural populations, children ≤10 in particular. Thus, the mapping of scorpions fauna in different Amazon localities is essential and must be accompanied by the characterization of the main biological activities of the venoms. Urban and farming planning, in parallel with awareness of workers at risk for scorpion stings on the need for personal protective equipment use should be considered as public policies for preventing scorpionism.

No MeSH data available.


Related in: MedlinePlus