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. 2015 May 13:21:13.
doi: 10.1186/s40409-015-0011-1. eCollection 2015.

Epidemiology of envenomations by terrestrial venomous animals in Brazil based on case reporting: from obvious facts to contingencies

Jean-Philippe Chippaux  1
Affiliations

Epidemiology of envenomations by terrestrial venomous animals in Brazil based on case reporting: from obvious facts to contingencies

Jean-Philippe Chippaux. J Venom Anim Toxins Incl Trop Dis. .

Abstract

Background: Envenomation remains a neglected public health issue in most tropical countries. A better understanding of the epidemiology of bites and stings by venomous animals should facilitate their prevention and management. This study aimed to explore the benefits that could be derived from the compulsory notification of cases as it is now routinely practiced in Brazil.

Methods: The Brazilian Notifiable Diseases Information System (SINAN) was consulted online for the 2001-2012 period on all envenomations by venomous terrestrial animals. We studied the incidence, severity, number of deaths, gender, season of accident and time between the accident and hospital consultation.

Results: In total, 1,192,667 accidents and 2,664 deaths from terrestrial venomous animals (snakes, scorpions, spiders, bees and caterpillars) were reported in Brazil during these 12 years, the circumstances of which are detailed in this study. Most envenomations and deaths were caused by snakebites and scorpion stings. However, incidence and mortality showed high regional variations. During this period, the steady and parallel increase of the cases from all the species resulted from several factors including the human population increase, gradual improvement of data collection system and, probably, environmental and socioeconomic factors affecting in a different way the incidence of envenomation by each zoological group and by region.

Conclusion: Mandatory reporting of cases appears to be a useful tool to improve the management of envenomations. However, local studies should be continued to account for the variability of accident circumstances and refine measures necessary for their management.

Keywords: Africanized bees; Brazil; Caterpillars; Envenomation; Epidemiology; Scorpions; Snakes; Spiders.

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Figures

Fig. 1
Fig. 1
Map indicating the five Brazilian macro-regions and their environmental characteristics
Fig. 2
Fig. 2
Trends of annual incidence of envenomations per 100,000 people in Brazil, 2001–2012
Fig. 3
Fig. 3
Trends of annual mortality following envenomations per 100,000 people in Brazil, 2001–2012
Fig. 4
Fig. 4
Age-specific snakebite incidence (per 100,000 people) in Brazil according to age group and region
Fig. 5
Fig. 5
Time elapsed between snakebite and medical care according to the region in Brazil
Fig. 6
Fig. 6
Age-specific scorpion sting incidence (per 100,000 people) in Brazil according to age and region
Fig. 7
Fig. 7
Age-specific spider bite incidence (per 100,000 people) in Brazil according to age group and region
Fig. 8
Fig. 8
Seasonal incidence of spider bites according to the region
Fig. 9
Fig. 9
Time to presentation at the hospital after spider bites according to the region
Fig. 10
Fig. 10
Seasonal incidence of bee stings according to the region
Fig. 11
Fig. 11
Notifications of snakebite and scorpion stings in Brazil at various periods according to the Brazilian Notifiable Diseases Information System (SINAN). (A) Snakebite notification. (B) Scorpion sting notification. SUS: Brazil’s Unified Health System. SIH: Hospital Information System
Fig. 12
Fig. 12
Relationship between snakebite incidence and human population density
Fig. 13
Fig. 13
Specific snakebite incidence according to age group and gender
Fig. 14
Fig. 14
Classification of scorpion stings from 2001 to 2012 in Brazil
Fig. 15
Fig. 15
Case fatality rate according to venomous animals and age groups
See this image and copyright information in PMC

References

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