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ABSTRACT: Scorpion stings comprise a serious problem throughout the globe, especially in regions where they are more frequent. In Morocco, Beni Mellal is one of the provinces most affected by this burden. This study aimed to trace the epidemiological profile of scorpion stings in Beni Mellal in order to improve patient care and prevent both morbidi...
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... January 2002 to December 2007, 8,340 cases of scorpion sting are recorded in Beni Mellal province ( Figure 1). From 2002 to 2007 the maximum number of scorpion sting cases (1,924 cases), registered in 2006, coincided with the awareness campaign; the respective yearly incidences were: 0.85‰, 1.22‰, 1.11‰, 1.8‰, 1.85‰ and 1.31‰ with an average of 1.36‰. Table 1 shows the characteristics of stung patients in the three health clinics: the polyclinics Fkih Ben Saleh, the polyclinics Tadla and the provincial hospital of Beni Mellal. These results showed that the average age of stung patients was 26.54 ± 18.42 years and that children ≤ 15 years accounted for 21.33% in Fkih Ben Saleh, 25.74% in Tadla and 38.11% in Beni Mellal. In the three health structures, the sex ratio favored females, because women are often in the outdoors, especially the farmland. The scorpion stings occurred most often during the summer months, peaking in July and August (Figure 2), with 59.8% between 6 pm and 6 am. As to the post-sting time (the time between the sting and a first consultation), the results showed that 67.3% of patients were able to receive medical attention in less than one hour. According to our analyses, 87.6% of stung victims came to a health center in Class I without a sign of seriousness; the patients in this class were only stung not envenomed. It should be noted that the Classes II (presence of one or more general signs) and III (cardiovascular, respiratory or neurological distresses) comprise 12.4% of cases, which is not negligible compared to other regions in ...
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Introduction and Objective: Scorpion stings are a common emergency in India
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Due to the medical and therapeutic importance of scorpions in Iranian traditional medicine, this review was conducted on the treatment of scorpion sting as performed by traditional healers in order to realize complications, clinical manifestations, diversities, and deficiencies in the prevention, control, and treatment as mentioned in the pertained...
Background: Poison Control Centre of Morocco (MPCC) plays a key role in promoting health. This study was aimed to demonstrate the role of the MPCC in improving public health and poisoning management. Methods: This was a retrospective study of poisoning cases reported to the MPCC between 1980 and 2011. The collected data included number of poisoning...
The present study was aimed at determining the epidemiological profile and risk factors of poisonings in the north central region of Morocco (Meknes-Tafilalet) in 2013-2014. The data collected from a survey that was carried out on the poisonings registered by health delegations and hospitals in the region in 2013 and 2014, in addition to poisonings...
Citations
... In Morocco, the scorpionism represents the most frequent cause of poisoning as reported by the Poison Control and Pharmacovigilance Center of Morocco ). The central regions of Morocco remain the most affected by scorpionic envenomation with many cases of death being recorded each year, particularly in the region of Beni Mellal Khenifra including Azilal province (Charrab et al. 2009). ...
... In Beni Mellal-Khenifra region, including Azilal province, scorpions have great medical importance and scorpionism remains a serious public health problem for local populations (Soulaymani et al. 2002;Charrab et al. 2009). ...
Background: Scorpionism is considered as one of the health and medical problem in undeveloped tropical and subtropical countries in the world. In Morocco, Azilal province is considered among the most Moroccan regions affected by the scorpion sting and envenomation. Despite of its epidemiological status, little is known about the distribution of scorpions in Azilal province. Any strategy against these envenomation must first go through a good knowledge of the composition and distribution of scorpion fauna involved. The current study aimed to study the scorpion fauna of this province in order to manage and control scorpionism related problems.Methods: In this field-laboratory investigation during 2014-2017, different localities of Azilal province were surveyed. 14 sampling localities were selected based on geographical situation, climate and local data. In the laboratory, the collected scorpions were determined morphologically based on the valid taxonomic keys.Conclusion: Our investigations in the Azilal province have allowed to us to inventory seven species. Among the inventoried species some are deemed dangerous for humans. The geographical distribution of collected species was discussed. The present work will be a complementary contribution to the comprehensive study of the scorpion sting syndrome in Morocco.
... The identification of the scorpion fauna and the classification of the epidemiological features of scorpion stings have been undertaken in several endemic regions, such as Algeria, Brazil, Iran, Mali, Mexico, Morocco, Nigeria, Saudi Arabia, Turkey [4][5][6][7][8][9][10][11][12][13][14][15]. ...
Objective:
To examine some epidemiological features of scorpion envenomations, analyse and interpret the recorded data, find any relationship between the incidence of scorpion stings and climatic factors, and finally develop a statistical model to estimate the variability among future cases in El Bayadh Province, Algeria.
Methods:
To assess the effects of climate variability on the scorpion envenomations, we applied the count data regression models to the monthly recorded scorpion stings in El Bayadh Province from 2001 to 2012.
Results:
The epidemiological analysis of data revealed that scorpion stings occured mainly in rural areas, round the clock, all year long with the highest seasonal incidence in summer, and the lowest in winter, all ages with male predominance. The ends of upper and lower limbs were the most affected parts of the human body. The majority of cases (95.7%) were classified as mild envenomations and systemic toxicity was observed in 4.3% of cases. The use of count data regression models showed that the negative binomial regression was appropriate to forecast cases and the fitted data agreed considerably with the actual data. Moreover, the model had predicted the monthly scorpion sting cases for the year of 2013, with satisfactory accuracy.
Conclusions:
This study shows an optimism for forecasting scorpion stings by modelling and calibration with surveillance data and climate information. This knowledge could help to contain any unusual situation and assist health decision-makers to strengthen the prevention and control measures and to be in a state of readiness.
... The results obtained in our experimental animals and in scorpion sting victims after administration of insulin as a therapeutic agent are also reviewed. K [19] . ...
Death due to poisonous scorpion stings is common in many tropical and subtropical countries. Scorpion envenoming syndrome causes stimulation of neuro-endocrine axis resulting in autonomic storm, intense stimulation of sympathetic nervous system, massive release of catecholamines, angiotensin II, suppressed insulin secretion, glucagon, glucocorticoids, increased free fatty acid levels, hyperglycemia, hyper-insulinemia, insulin resistance, acute myocarditis, initial hypertension, hypotension, arrhythmias, conduction defects, ischemia, infarction, acute pancreatitis, CNS damage, motor aphasia, hemiplegia, mydriasis, hyperhidrosis, acute respiratory distress syndrome, disseminated intravascular coagulation, multi system organ failure, shock and death. The scorpion envenoming syndrome also causes stimulation of immuno-pathological axis, systemic and local inflammation, increase in production of proinflammatory cytokines IL-1α, IL-1β, IL-4, IL-6, IL-10, IL-12, TNF-α, IFN-γ and NO and contribute to immunological imbalance, hyperglycemia, hyper-insulinemia, insulin resistance, multi-system organ failure, shock and death. Elevated levels of TNF-α cause impaired glucose tolerance and induce insulin resistance for endogenously secreted insulin. Insulin administration reversed metabolic, respiratory changes, cardiogenic and non-cardiogenic pulmonary edema, electrocardiographic, cardiovascular changes and many other manifestations in our experimental animals and in our scorpion sting victims with scorpion envenoming syndrome. Treatment: Continuous infusion of regular crystalline insulin at the rate of 0.3 U/g glucose and glucose at the rate of 0.1g/kg body weight/h, for 48–72 h, with supplementation of potassium as needed, maintenance of fluid, electrolytes, acid-base balance.
... In addition, the scorpion stings most frequently at night between 18:00 p.m. and 6:00 a.m. These results are in accordance with similar data reported by other authors [1,8,19,20], which basically reflect the nocturnal habits of the scorpions [8,21,22,25,38,39]. ...
Abstract
Scorpion stings comprise a serious public health problem throughout the globe, especially in regions where they are more frequent. In Morocco, El Kelâa des Sraghnas is one of the provinces most affected by this burden. This retrospective study aimed to trace the epidemiological profile of hospitalized stung patients (class II and III) and to determine the clinical sign related to the death by scorpion envenomation. Our work is an analytical study of scorpion stings based on hospital files of stung patients referred during 2002 to 2006. The objective is to identify the clinical signs associated with death by envenomation scorpions (classe II and III), based on hospital files of the hospital Essalama in El Kalaa des Sraghnas. Data were analyzed using the SPSS version 20 and STATISTICA version 9. The descriptive analysis focused on the sociodemographic parameters (age, sex, time after sting), clinical and therapeutical features. 896 patients were included in this study. The sex ratio is close to 1 and the median age was 18.76 ± 0.65. All age groups were affected by this problem, with a higher lethality rate in children aged less than or equal to 15 years (14.5%). Moreover, the stings were more frequent at night between 6:00 pm. and 6:00 am. The analysis of the various factors influencing the death showed that the priapism in boys, vital distress and Glasgow Coma Scale at admission , are risk factors in determining the vital prognosis of patients. Also, the analysis of lethality evolution showed that its rate remains high despite the Moroccan strategy against scorpion stings. The results of our study clearly displayed that scorpion envenomation remains a public health problem in Morocco. Favourable evolution was in 90.3% of cases. 87 deaths were recorded (9.7%). The priapism, the different distress (cardiovascular, respiratory, neurological) and the classe III at admission, are statistically significant and associated with death (p<0.001).
Keywords: Scorpion, Sting, envenomation, epidemiology, Risk factors, vital distress, El Kelâa des Sraghnas, Morocco
... Les circonstances volontaires avaient représenté 3 fois plus de chance d'être mortelles. dans différentes régions du Maroc [ 17, 18, 19, 20, 21, 22] . Le sexe féminin était le plus touché (62%), ce qui rejoint les données des investigations réalisées, sur l'ensemble du territoire marocain [ 6] . ...
Abstract
The objective of this work is to describe the epidemiology of poisoning in the region of Fez-
Boulemane, and detect the risk factors influencing the evolution of poisoned patients. A
retrospective descriptive analysis was carried out on 1508 poisoning. Data are collected from
two information systems - the Toxico-vigilance and toxicological information, suspected or
proven Anti Poison Centre of Morocco (CAPM) from 1 January 2007 to 31 December 2011.
Entry and statistical analysis is done on Epi Info 2002. Depending on the results, the average
age of the population was addicted to 16.9 ± 21.6 years, the sex ratio (Female / Male) of 1.6.
The gaseous products were the products most offending, with 50% of cases. The outcome was
favorable in 97.7% of cases, 7 cases (0.5%) with ongoing sequel and 25 cases (1.8%) have
died. The study of the effect of the studied parameters on the evolution of the health status of
patients has led to progress as follows: the relative risk was respectively (CI95% : 1,68-21,27),
2,31 (CI95% : 1,12-4,87), 2,14 (CI95% : 1,16-3,95) et 3,02 (CI95% : 1,41-6,62)
Scorpion stings are a major public health concern representing a frequent cause of intoxication in many countries. The present study aims to examine the impact of climate variability in different climatic regions of the state of Morelos in Mexico on the incidence of scorpion stings. An ecological study was conducted using a retrospective time-series analysis. Weekly reported scorpion sting cases from the Unique System of Information for Epidemiological Surveillance (SUIVE) and daily temperature and precipitation from the National Meteorological Service were obtained from 1999 to 2007. The geographical region of study was divided according three climatic conditions into Hot region (HR), Warm region (WR) and Cold region (CR). Generalized Linear Models were used to estimate the percent change [95% confidence intervals (CI)] of scorpion sting cases associated to an increase of 1 °C of temperature and 1 cm of precipitation in each climatic region. During the period of study there were 281 076 scorpion sting cases reported in the State of Morelos, Mexico. Positive correlations among temperature and scorpion sting cases were found (R = 0.59 and 0.70 in the HR and WR, respectively). Regions with the hottest temperatures had the greatest effect, showing a 9.8% (CI 95%: 8.30–11.30) increase in scorpion sting cases per 1 °C increased in temperature. Increase in minimum and maximum temperatures have a delayed effect on scorpion stings cases and these may vary by climatic region.
OBJECTIVES:
The aims of this study were to highlight some epidemiological aspects of scorpion envenomations,
to analyse and interpret the available data for Biskra province, Algeria, and to develop a forecasting model for scorpion sting cases in Biskra province, which records the highest number of scorpion stings in Algeria.
METHODS:
In addition to analysing the epidemiological profile of scorpion stings that occurred throughout
the year 2013, we used the Box-Jenkins approach to fit a seasonal autoregressive integrated moving average (SARIMA) model to the monthly recorded scorpion sting cases in Biskra from 2000 to 2012.
RESULTS:
The epidemiological analysis revealed that scorpion stings were reported continuously throughout
the year, with peaks in the summer months. The most affected age group was 15 to 49 years old, with a male predominance. The most prone human body areas were the upper and lower limbs. The majority of cases (95.9%) were classified as mild envenomations. The time series analysis showed that a (5,1,0) × (0,1,1)12 SARIMA model offered the best fit to the scorpion sting surveillance data. This model was used to predict scorpion sting cases for the year 2013, and the fitted data showed considerable agreement with the actual data.
CONCLUSIONS:
SARIMA models are useful for monitoring scorpion sting cases, and provide an estimate of the variability to be expected in future scorpion sting cases. This knowledge is helpful in predicting whether an unusual situation is developing or not, and could therefore assist decision-makers in strengthening the province’s prevention and control measures and in initiating rapid response measures.
KEY WORDS:
Algeria, Biskra, Epidemiology, Forecasting, Scorpion stings, Time series
Scorpion stings comprise a serious problem throughout the globe, especially in regions where they are more frequent. In Morocco, Beni Mellal is one of the provinces most affected by this burden. This study aimed to trace the epidemiological profile of scorpion stings in Beni Mellal in order to improve patient care and prevent both morbidity and mortality. Our work is a retrospective study of scorpion stings based on medical charts of Beni Mellal. From 2002 to 2007, 8,340 cases were registered in this province with an average incidence of 1.36‰. The stings were more frequent in summer months, particularly July and August, and between 6 p.m. and 6 a.m. (59.8%). The average age of victims was 26.54 ± 18.42 years. Children were affected in 30.3% of the cases. Of all registered cases, 67.3% of the patients received medical aid in less than an hour after the sting. The envenomation rate (Class II and Class III) was 12.4% and the overall case-fatality rate was 0.42% with a mortality rate of 0.005‰. Statistical analysis of the various studied factors revealed a significant connection among the envenomation class, patient age and evolution.
Around the world and especially in summer, the scorpion envenomation is a real public health problem. In Morocco, its gravity is due to the diversity of genera of the Buthidae family whose their venom is potentially lethal, mainly the genus Androctonus, Buthus and Hottentota. The areas most affected by this problematic are the central and southern of Morocco. The lethality of scorpion's venom primarily affects children. It is rich in neurotoxic polypeptides that have targeted ion channel membrane Na(+), K(+) activated or not by Ca(++). The toxins polymorphism causes pathophysiological disorders. The diversity of symptomatic treatment in the absence of immunotherapy is due to variability in clinical pictures, which depends on the species involved and the patient at risk. The objective of this review is to highlight the magnitude of the scorpion envenomation by describing its epidemiological characteristics, elucidate the pathophysiological effects of the venom of the most dangerous scorpions in Morocco the genus Androctonus, Buthus and Hottentota, and their therapeutic treatment.
L’objectif de ce travail est de décrire les cas d’intoxications enregistrés dans la région de Marrakech-Tensift-Al Haouz qui est l’une des 16 régions du Maroc les plus touchées par ce problème. Une étude rétrospective a été réalisée sur les cas d’intoxications déclarés entre 1981 et 2008 au centre antipoison et de pharmacovigilance du Maroc (CAPM). Durant la période d’étude, 8 517 cas ont été collectés. L’âge moyen des patients était de 22 ± 15 ans. Le sex-ratio homme/femme était de 0,85. Les aliments étaient les produits les plus incriminés, avec 26,6 % des cas. Parmi les 2 779 patients pour lesquels l’évolution est connue, 65 sont décédés, soit une létalité de 23,4 ‰. La létalité maximale a été enregistrée chez les intoxiqués par la paraphénylènediamine (170,7 ‰).
