Effects of climate variables on the incidence of scorpion stings in Iran for five years

Background: Although scorpionism is recorded worldwide, some regions such as Iran present a higher incidence. Due to the great prevalence of scorpion stings in Khuzestan province, southwestern Iran, the present study examined the relationship between different climate parameters and the scorpion sting rate in this area from April 2010 to March 2015. Methods: In this cross-sectional descriptive-analytical study, we considered all scorpion sting cases recorded in the Department of Infectious Diseases, Ahvaz Jundishapur University of Medical Sciences. Data were analyzed using statistics, frequency distribution and Pearson's correlation coefficient. Results: A total of 104,197 cases of scorpion stings was recorded from 2010 to 2015. The cumulative incidence of scorpion sting was 2.23%. The spatial distribution of scorpion stings showed that most cases occurred in the Dehdez district (4,504 scorpion stings/100,000 inhabitants) and the Masjed Soleyman county (4,069 scorpion stings/100,000 inhabitants). A significant association was found between climate factors (temperature, evaporation rate, sunshine duration, humidity, and precipitation) and the scorpion sting rate. An increase in rainfall and humidity coincided with a reduction in scorpion stings whereas an increase in temperature, evaporation, and sunshine duration was accompanied by a growth of scorpion stings. No significant correlation was found between wind velocity/direction and the incidence rate of stings. Moreover, the seasonal peak incidence of scorpion stings was recorded in summer (an average of 8,838 cases) and the lowest incidence was recorded during winter (an average of 1,286 cases). The annual trend of scorpion sting cases decreased during the period from 2010 to 2015. Conclusion: Climate variables can be a good index for predicting the incidence of scorpion stings in endemic regions. Since they occur mostly in the hot season, designing preventive measures in the counties and districts with a high incidence of scorpion stings such as Dehdez and Masjed Soleyman can minimize mortality and other burdens.(AU)

Scorpion stings in pregnancy: an analysis of outcomes in 66 envenomed pregnant patients in Iran

Scorpionism is one of the most important health problems in tropical regions, which unfortunately results in thousands of deaths annually. Pregnant women are potential victims in areas with high scorpion-sting prevalence. Limited medical data are available on the effects of scorpion envenomation in pregnant women. This study aimed to examine the effect of scorpion envenomation on pregnancy outcomes in 66 cases. Methods: The present descriptive/analytical cross-sectional study was performed on 66 scorpion-envenomed pregnant women referred to the clinical toxicology unit of Ahvaz Razi Hospital in Iran during 2015-2017. The variables assessed in all cases, via questionnaire and hospital medical records, were: age, patient residency, gestational week, status of the fetus, laboratory anomalies, clinical severity of envenomation, sting site and scorpion species. Pregnancy outcome (miscarriage, stillbirth, preterm birth, normal delivery) and status of the newborns were also evaluated. Data were analyzed using SPSS ® software (version 24.0). Results: The following pregnancy outcomes were recorded from envenomed pregnant women: miscarriage = 1.5% (n = 1), stillbirth = 4.5% (n = 3), preterm birth = 10.6% (n = 7), normal birth = 83% (n = 55). Among participants whose pregnancy led to birth, 11(17.7%) cases had prenatal-neonatal complications. Neonatal complications, including Apgar score less than 8 points at 5 min, were found in 7 (11.3%) preterm birth cases and in 4 (6.4%) normal birth cases, along with birth weight below 2500 g in normal births. A significant relationship was found between adverse pregnancy outcomes and bite location, as well as scorpion species, but no relationship was found with other variables. Conclusion: Envenomation significantly contributes to preterm birth. Moreover, the location of bites and the type of scorpion species have a decisive role in the pregnancy outcome of scorpion-envenomed pregnant women.(AU)