Scorpion Sting Envenomation, a Neglected Tropical Disease: A Nationwide Survey Exploring Perspectives and Attitudes of Resident Doctors from India

Abstract

Scorpion sting envenomation (SSE) is a commonly encountered and a significant problem in the tropics, affecting rural and marginalized communities. However, it is not formally listed as a neglected tropical disease (NTD) by the WHO. We designed this cross-sectional study to explore medical graduates' and resident doctors' perspectives on SSE as an NTD and to assess their experiences, knowledge, and confidence in managing these patients. An online questionnaire was developed, validated, and administered to interns and resident doctors across India. Adjusted odds ratios were calculated for factors predicting high self-reported confidence scores for managing scorpion stings using multivariable logistic regression. The final questionnaire contained 26 items including participant background, perspectives about SSE being an NTD, experiences, knowledge, and skills needed to manage, and prevent stings effectively. Of 454 participants, 69% opined that SSE was an NTD, and > 60% felt that SSE was inadequately addressed within undergraduate training. Predictors of high self-reported confidence scores in management competencies were residency in a clinical branch that commonly encountered SSE (internal/emergency medicine or pediatrics, P < 0.0001), having ever managed an SSE patient alone or as a part of a team (P < 0.0001), and attending a class or teaching session on SSE during undergraduate training (P = 0.048). Our results suggest that residents across India believe that there is an urgent need to declare SSE an NTD to increase its visibility, further paving the way for innovative multilevel cross-cutting solutions for mitigation. Designing authentic learning experiences can help produce competent and empathetic physicians in managing and preventing SSE.

Figure 1.

Stepwise process followed for evolving the study questionnaire.

Figure 2.

State/union territory wise distribution of bachelor of medicine/bachelor of surgery training of participants (N = 454) (Map created using academy.datawrapper.de. Link to base-image-https://app.datawrapper.de/map/04X4f/basemap).

Figure 3.

Multipaneled figure showing participant responses to items 19, 20, 21, and 24 of the questionnaires. SSE = scorpion sting envenomation.