Epidemiologicalpprofile of snakebite accidents in a metropolitan area of northeast Brazil / Perfil epidemiologico dos acidentes por picada de cobra em regiao metropolitana do nordeste do Brasil

SUMMARY The aim of this study was to describe the epidemiological profile of snakebite accidents reported by the toxicological assistance center in Fortaleza, Ceará, Brazil. Database information on snakebite accidents was analyzed regarding the period from January 2003 to December 2011. A total of 1063 cases were found. The accidents occurred during the rainy months (March, April and May), in urban areas (52.3%), affecting individuals younger than 50 years and predominantly among males (70.7%). The lower limbs were the most frequently affected body area (33.7%). Most accidents involved non-venomous snakes (76.1%). The genus Bothrops was the main one involved in venomous accidents (83%). It is expected that this study can be used as the substrate to improve healthcare surveillance and implementing better measures for the treatment of this population. .

RESUMO O objetivo deste estudo é descrever o perfil epidemiológico dos acidentes ofídicos atendidos e notificados ao Centro de Assistência Toxicológica (CEATOX), em Fortaleza, Ceará, Brasil. Foram analisadas informações sobre os acidentes ofídicos relativos ao período compreendido entre janeiro de 2003 a dezembro de 2011, por meio de banco de dados. Os resultados demonstraram 1063 casos notificados ao CEATOX, Ceará. Os acidentes ocorreram principalmente em meses chuvosos (março, abril e maio), em áreas urbanas (52,3%), em uma faixa etária menor de 50 anos, acometendo predominantemente o sexo masculino (70,7%). Os membros inferiores foram os locais mais afetados (33,7%). A maior parte dos acidentes envolveu serpentes não peçonhentas (76,1%). O gênero Bothrops foi o maior responsável pelos acidentes com serpentes peçonhentas (83%). Espera-se que os dados da casuística obtida sirvam de ferramenta para o planejamento de medidas de saúde voltadas para prevenção e atendimento mais adequado da população em estudo. .

Epidemiology of snakebite accidents in the municipalities of the state of Paraíba, Brazil / Epidemiologia dos acidentes ofídicos ocorridos nos municípios do Estado da Paraíba, Brasil

Acidentes por animais peçonhentos representam um importante, embora negligenciado, problema de saúde pública mundial. Neste sentido, foi realizado um estudo descritivo dos acidentes ofídicos atendidos e registrados, entre 2007 e 2010, nas unidades de saúde dos municípios do Cariri, Estado da Paraíba, Nordeste do Brasil. As informações foram coletadas do banco de dados do Sistema de Informação de Agravos de Notificação do Ministério da Saúde. Um total de 351 registros de vítimas de ataques por serpentes peçonhentas foram analisados. As vítimas foram predominantemente trabalhadores rurais do sexo masculino com mais de 50 anos. As maiores incidências de acidentes ofídicos ocorreram em áreas rurais, entre abril e junho de 2007 e 2010. As serpentes do gênero Bothrops foram responsáveis pela maioria dos casos, e as vítimas foram, em sua maioria, picado nos pés. A maioria das vítimas recebeu assistência médica no prazo de 1h a 3h após a picada. As manifestações clínicas mais comuns foram dor, edema e equimoses, classificadas como leve ou moderada. Duas mortes foram relatadas. Os resultados deste estudo podem contribuir para identificar as condições que aumentam o risco dos acidentes ofídicos na Região Nordeste.

Accidents involving venomous animals represent an important, albeit neglected, public health issue worldwide. A descriptive study was made of snakebite cases attended and recorded between 2007 and 2010 in the health units of the municipalities of Cariri, State of Paraíba, northeastern Brazil. Data was collected from the Injury Notification Information System data banks of the Health Ministry and a total of 351 records of snakebite victims were reviewed. Victims were predominantly male farm workers over 50. The highest incidence of snakebites occurred in rural areas, between April and June of 2007 and 2010. Snakes of the genus Bothrops were responsible for most cases, and victims were mostly bitten on the feet. The majority of the victims received medical assistance within 1 to 3 hours after being bitten. The most common clinical manifestations were pain, edema and ecchymosis, which were mainly classified as mild or moderate. Two deaths were reported. It was concluded that there is a significant impact of seasonality in snakebites, the prevalence of attacks caused by Bothrops, affecting the lower limbs of adult male farmers in rural areas. The findings of this study may contribute to identify the conditions that increase the risk of snake attacks in the northeastern region.

Epidemiología clínica y laboratorial por mordeduras de serpientes en pacientes hospitalizados

The aim of this study was to evaluate the epidemiological, clinical and laboratory of the snakebite accidents in children and adults of both genders who were hospitalized in the Institute of Tropical Medicine in the period January 2009 to February 2010.Materiales Methods: Retrospective, observational, transverse section. Results and Conclusion: From a total of 126 cases of snakebite accidents. The males had higher prevalence 71.4% (90/126), aged between 10-19 years to 23.3% (29/126). The most frequent cases in 2009 February was 16% (20/126) and 2010 January 14% (14/126). What differs with the study of Vera, Caceres Paez and Gamarra, Paraguay it was found that the months with the highest incidence of snakebite accidents is March and abril. 8 regard to the health region the department with more cases was Cordillera with 26.2% (33/126). The genus Bothrops sp. was responsible for the increased frequency of accidents. The most common clinical manifestations were local: 37% (45% / 126) Edema and 28% (37/126) pain. The most obvious complications were 33% (8 / 24) acute renal failure, 29% (7 / 22) anemia, 13% (3 / 24) Disseminated intravascular coagulation, 13% (3 / 24) Necrosis, 8% (2 / 24) Cellulite and 4% (1 / 24) abscesses. Regarding laboratory data, we observed that 75% (95/126) of prothrombin time values were decreased 59% (74/126) Partial Prothrombin Time increased to 64% (81/126) Fibrinogen decreased. While, 70.6% (89/126) of urea and 54.5% (67/123) of creatinine was within normal limits

El objetivo de este trabajo fue evaluar las características epidemiológicas, clínicas y laboratoriales de los accidentes por mordeduras de serpientes en niños y adultos hospitalizados en Instituto de Medicina Tropical en el periodo de enero del 2009 al febrero del 2010. Materiales y Método: Estudio retrospectivo, observacional, de corte transverso de pacientes hospitalizados en el Instituto de Medicina tropical entre enero de 2009 y febrero de 2010 con mordeduras de serpientes. Resultados: De un total de 126 casos de accidentes ofídicos. El sexo masculino presentó mayor prevalencia 71,4% (90/126), en edades comprendida entre 10-19 años con un 23,3% (29/126). Los casos más frecuentes en el 2009 se observaron en el mes de febrero 16% (20/126), y en el 2010 en el mes de enero 14% (14/126).Lo que difiere con el estudio de Vera, Páez y Gamarra de Cáceres, Paraguay que se encontró que los meses con más incidencia de accidentes ofídicos es marzo y abril.8 Respecto a la región sanitaria el departamento que presentó mayor casos fue Cordillera con un 26,2% (33/126). El género Bothrops sp., fue responsable de la mayor frecuencia de accidentes. Las manifestaciones clínicas locales más comunes fueron: 37% (45/126) Edema y 28%(37/126) dolor. Las complicaciones más evidentes fueron 33% (8/24) insuficiencia renal aguda, 29% (7/22) anemia, 13% (3/24) Coagulación Intravascular diseminada, 13% (3/24) Necrosis, 8% (2/24) Celulitis y 4% (1/24) Abscesos. En cuanto a los datos laboratoriales, se observó que el 75% (95/126) de los valores de Tiempo Protrombina estaban disminuido, 59% (74/126) el Tiempo Parcial de Protrombina aumentado y el 64% (81/126) Fibrinógeno disminuido. En tanto que, el 70,6% (89/126) de la Urea y 54,5% (67/123) de la Creatinina se encontró dentro de los valores normale