Epidemiology of scorpion stings in the West Bank, occupied Palestinian territory.

Background: Scorpionism (scorpion sting envenoming) is an endemic public health concern in many Arab Middle Eastern countries. However, our knowledge of the epidemiology of scorpion stings in the West Bank is limited. Aim: To investigate the epidemiology of scorpion stings in 4 districts of the West Bank over a specified period. Methods: We obtained scorpion sting records from the main hospitals in 4 districts of the West Bank for 2012 and 2014-2020. A total of 2175 cases were analyzed retrospectively using SPSS version 17. Results: The average age and standard deviation (±SD) for both sexes was 24.7±17.5 years (22.7±16.5 and 27.1±18.4 years for males and females, respectively). The median age was 20 years and 47.2% were children under 18 years. Most cases were reported during the summer months, between June and October, with a peak in July-August. By anatomic site, the right hand was the most commonly stung in both sexes, followed by the right foot. The chest, buttocks and scrotum were the least affected body parts. Clinical data were available for 405 cases, in which pain, vomiting and sweating were the most common symptoms. The overall incidence of stings was 26.32 per 100 000 inhabitants per year over the study period of 8 years (59.21-171.67, 95% CI). Conclusion: Scorpion stings are commonly encountered by adults and children in the West Bank. There is a need for awareness among the West Bank populations on how to avoid being stung, to train medical staff to better manage sting cases, and to evaluate the antivenom currently being used by physicians for scorpion stings.

Morphometric and meristic diversity of the species Androctonus crassicauda (Olivier, 1807) (Scorpiones: Buthidae) in Saudi Arabia.

Intraspecific molecular and morphological variations among geographically isolated populations are useful for understanding the evolutionary processes, which is considered early stage of allopatric speciation. Also, the knowledge of the regional variation of scorpion venom composition is needed to improve antivenom therapeutic management. Androctonus crassicauda (Olivier, 1807) is the most common and medically important species in Arabia and the Middle East. Therefore, this study aimed to investigate the geographic morphological variation among A.crassicaudapopulations, regarding its geographical distribution in unexplored arid regions in Saudi Arabia. Samples were collected and examined morphologically under a dissecting microscope from different four eco-geographical regions. The results of ANOVA and multivariate statistical analyses provide strong evidence of geographical variation. The two populations from OTU3 and OUT4 showed the greatest degree of morphological difference from populations of OUT1 and OUT2. Each OTU3 and OTU4 populations showed significant speciation without overlapping in the two groups, while the remaining overlapped groups comprised two other populations. Several body variables influenced male separation, including carapace posterior width, metasoma 3rd length, and metasoma 2nd length. For females, telson length, metasoma 1st width, and sternite 7th width were highly influential variables. Such variation may suggest the existence of cryptic taxa within A. crassicauda populations in Saudi Arabia. Moreover, metasoma ratios can be used as good indicators in intraspecific variation studies of Scorpions.

Epidemiology of snakebites in Kuwait.

Fifty-two confirmed cases of snakebites in Kuwait were recorded during 2015-2019. The male:female ratio was almost 2:1 and 84.6% of the victims were between 1 and 20 y of age and 14.4% were >30 y. Snakebites peaked in October (23.1%) and July (17.3%), with the lowest number of recorded cases in March.

Scorpions and scorpion sting envenoming (scorpionism) in the Arab Countries of the Middle East.

The twelve Arab countries of the Middle East are inhabited by 117 species of scorpions of varying medical importance within six families. Scorpion stings are a very common occurrence throughout the region. Twenty-two scorpion species are considered to be dangerously venomous, causing potentially life threatening stings. Accessible literature in English and Arabic on scorpions, scorpion stings and available antivenoms was reviewed to document the scorpion fauna and scorpion stings in each country. Saudi Arabia, Iraq and Jordan report the highest numbers of stings and envenomings. Clinically, the most important toxins in Old World scorpion venoms are α-toxins that target voltage-gated sodium (Nav) channels at neurotoxin binding site 3, causing sympathetic excitation and the endogenous release of catecholamines that is responsible for transient, but life-threatening myocardial damage. Most victims of scorpion stings suffer severe local pain, but a few, especially children, develop systemic envenoming which, in the case of most Middle Eastern buthid species, such as Androctonus and Leiurus species, is dominated by the cardiovascular and respiratory consequences of hypercatecholinaemic myocarditis. Other syndromes include paralysis (Parabuthus leiosoma), coagulopathy (Nebo hierichonticus and Hemiscorpius species), and local tissue damage, haemolysis and acute kidney injury (H. lepturus). Early antivenom treatment is recommended but its value remains controversial. However, intensive care, with the ancillary use of vasoactive drugs such as prazosin and dobutamine, has proved effective.

Terrestrial venomous snakes and snakebites in the Arab countries of the Middle East.

The 12 Arab countries of the Middle East are inhabited by 21 species of terrestrial venomous snakes of varying medical importance. This review considers these species, consisting of 16 viperids, 3 elapids and 2 atractaspidines. Iraq, Jordan, Lebanon, Oman, Saudi Arabia, and Yemen report the largest numbers of snakebites and envenomings. Accessible literature in English and Arabic on venomous snakes and snakebites and available antivenoms is reviewed. Clinical effects include potentially misleading symptoms attributable to anxiety and traditional pre-hospital treatments.

Cutaneous leishmaniasis among Syrian refugees in Jordan.

INTRODUCTION: Old World cutaneous leishmaniasis (CL) is one of the most prevalent vector-borne diseases within the World Health Organization's Eastern Mediterranean Region. The conflict in the Syrian Arab Republic generated large population movements and raised concerns about spreading of CL to countries where Syrians have relocated, including Jordan. METHODS: A review of electronic and paper-based registries of CL cases in Jordan was conducted to assess burden of disease and associated socio-demographic factors. RESULTS: Increasing numbers of CL cases have been reported in Jordan between 2010 and 2016 (from 140 to 281), paralleled by significant increases in incidence rate (from 2.09 per 100 000 person-years, 95% CI (1.77-2.47), to 2.87 per 100 000 person-year, 95% CI (2.55-3.22), p = 0.002) and in the proportion of cases who are Syrian (from 8.6%-55.2%, p < 0.001). Syrian refugees have higher odds of presenting with leishmaniasis than Jordanian nationals (adjusted OR 7.1, 95% CI (6.3-8.0), p = 0.000). CONCLUSIONS: Presence of large numbers of Syrian refugees within Jordan has so far not contributed to increased risk of developing CL for Jordanians, however surveillance, diagnosis and case management for CL should be reinforced to meet the increased burden. Electronic surveillance can help identify priority populations and areas for interventions.

Horse flies and their seasonal abundance in El Tarf Province of northeastern Algeria.

The horse flies of El Tarf Province, northeastern Algeria comprise 15 species within two subfamilies (Chrysopsinae and Tabaninae) belonging to five genera (Atylotus, Chrysops, Dasyrhamphis, Haematopota, and Tabanus). The genera Chrysops, Dasyrhamphis, and Haematopota are represented by two species for each, while the genera Atylotus and Tabanus are represented by four and five species, respectively. Seasonal abundance was assessed from mid-March until the end of September, 2017 for the trapped species. Haematopota pluvialis and Tabanus autumnalis appeared in April and lasted until September with a peak in May. Atylotus agrestis appeared in May with the highest density and lasted until September. Atylotus fulvus, Atylotus kroberi, and Haematopota italica emerged in April with peaks in May, while Chrysops flavipes appeared in March, reaching its peak in May and June, declining in July, and disappearing thereafter. Atylotus flavoguttatus, Chrysops mauritanicus, and Dasyrhamphis tomentosus appeared in April with a peak in June, then disappearing in August. Tabanus nemoralis started to appear in April with a peak in May and disappearance after July. Dasyrhamphis algirus, Tabanus bromius, and Tabanus eggeri started to appear in May. Both Tabanus eggeri and Dasyrhamphis algirus peaked in June and July, whereas T. eggeri lasted until the end of September. Tabanus tinctus was observed in June with a peak in August and lasted until September.

Systematics, distribution and ecological analysis of rodents in Jordan.

Distributional and ecological data were given to all rodents of Jordan. The rodent fauna of Jordan consists of 28 species with 20 genera in eight families (Cricetidae, Dipodidae, Gliridae, Hystricidae, Muridae, Myocastoridae, Sciuridae,and Spalacidae), including four introduced species.Keys for families and species were provided, along with diagnosis for each species and cranial illustrations for most species. Habitat preference and zoogeographic affinities of rodents in Jordan wereanalyzed, as well as their status and conservation.Threat categories and causes of threats on the rodents of Jordan were also analyzed.        The distribution of rodents in Jordan represents a reflection of their global distribution ranges and habitat preferences. Species associated with the temperate forest of northern Jordan includes Sciurus anomalus and two wood mice, Apodemus mystacinus and A. flavicollis, while non-forested areas are represented by Nannospalax ehrenbergi and Microtus guentheri. Strict sand dwellers include Gerbillus cheesmani and G. gerbillus. Petrophiles associated with sandstone or black lava deserts are exemplified by Acomys russatus, A. r. lewsi, H. indica and S. calurus. Others including: Jaculus jaculus, G. nanus, G. henleyi, Meriones crassus, and M. libycus are all desert-adapted species with wider ranges of distribution where scarce vegetation, wadibeds, and marabs with clay, loess, or gravel surfaces provide foraging grounds and shelter. A single species, Gerbillus dasyurus, exhibits a wide range of distribution over diverse habitat types.        The rodent fauna of Jordan consists of assemblages of different zoogeographical affinities. Nine, three, and seven were restricted or had most of its range within the Mediterranean, Irano-Turanian, and Saharo Arabian, respectively. Sciurus anomalus, Apodemus sp., Nannospalax ehrenbergi, and Microtus guentheri reached their most southern range of distribution in the Mediterranean regions of Jordan. The distribution of Gerbillus cheesmani extends from Asian deserts in India westwards into the Arabian Peninsula crossing Jordan as its most western range of distribution. Typical rodents of Saharo-Arabian affinities are represented by desert jerboas, gerbils, and jirds. North African species such as G. andersoni, G. gerbillus reached their most eastern distribution in southern Jordan. Both G. henleyi and G. nanus are widely-distributed species across North Africa reaching as far as India to the east, representing most northern outpost for these two species. Sekeetamys calurus is a nearly endemic to the Eastern Mediterranean region within southern Jordan and Sinai. Relicts are represented by Eliomys melanurus and Acomys russatus lewisi.        Several threats affecting the rodent biodiversity in Jordan were identified including habitat loss and degradation, human disturbance and related activity, legislative and public awareness. The global conservation status of the rodents of Jordan according to the IUCN Red List include 22 species as least concern, one as near threatened (Allactaga euphratica), and one as data deficient (Nannospalax ehrenbergi). According to the regional assessment, one species is critically endangered, three species are considered endangered, one vulnerable.

Scorpion Stings in Jordan: An Update.

OBJECTIVE: Scorpionism is an endemic public health problem in Jordan encountered by health providers in all parts of the country. This study updates epidemiological data on scorpion sting encounters in Jordan. METHODS: Data on scorpion sting encounters were obtained from government and military hospitals around the country, and the National Drug and Poison Information Center (NDPIC). P values and 95% confidence intervals (CIs) were calculated using SPSS Professional Statistics Package version 22 (IBM Corp., Armonk, NY) program. RESULTS: Epidemiological data on 1205 scorpion sting cases reported between 2006 and 2012 are reported. Male to female ratio was 1.18:1, aged 23.3±16 (mean±SD) and 26.4±16.9 years for males and females, respectively. Age groups between 1 to 20 years old constituted 44.6% of the total sting encounters, while adults aged >30 years constituted 30%. Scorpion sting encounters peaked in July (22.5%) and August (23%), with the lowest numbers of recorded cases in February and January (1.6 and 1.9%, respectively). Scorpion stings occurred mostly outdoors (66%). Medical complications associated with scorpion sting cases included fever, difficulty in breathing, drowsiness and dizziness, and numbness, while severe complications include respiratory failure and tachycardia. Hospitalization required 1 to 3 days among admitted patients with no fatalities. CONCLUSIONS: Scorpion stings remain a medical problem in Jordan that requires more attention by health providers. Reporting of scorpion sting cases should be enforced from all healthcare centers throughout the country to better understand the epidemiology and health implications of human encounters.

Diversity, ecology, and seasonality of sand flies (Diptera: Psychodidae) of the Jenin District (Palestinian Territories).

The diversity, ecology, and seasonality for sand flies from two localities in Jenin District, the Palestinian Territories, were studied. A total of 12,579 sand flies (5,420 Phlebotomus and 7,159 Sergentomyia) were collected during the study period. The genera Phlebotomus and Sergentomyia are represented by 13 and nine species and subspecies, respectively. Species account was given for all collected species. CDC light traps yielded 7,649 (60.8%) of the total captured sand flies, while sticky traps and aspirators contributed to 36.4 and 2.8% of the total collected specimens, respectively. Phlebotomus sergenti and P. syriacus showed two peaks, one in July and one in October. Phlebotomus tobbi showed one peak towards the end of the summer in September and August, while P. papatasi showed a bimodal peaks pattern, one in June and one in October. Phlebotomus canaaniticus showed a peak in August. P. perfiliewi transcaucasicus and P. neglectus showed a peak in October. Sergentomyia dentata showed one peak in August and increasing numbers from June to August, declining afterwards. Other species, such as S. theodori, had one peak in June, S. taizi had steady numbers across the summer, and S. christophersi had a peak in August.

Infestation and seasonal activity of Ixodes vespertilionis Koch, 1844 (Acari: Ixodidae) on the Maghreb mouse-eared bat, Myotis punicus Felten, 1977, in northeastern Algeria.

Infestation of Ixodes vespertilionis Koch, 1844 on Myotis punicus Felten, 1977 from two sites (Trios Tunnel and Sidi Trad cave) in northeastern Algeria was studied. An overall infestation of 41.4% for all stages was found among bats collected from both sites. By stage, a total of eight females, 70 nymphs, and 107 larvae were recovered from both populations. The number of females recovered per bat at Sidi Trad ranged from 0-1, for nymphs 0-2, and for larvae 0-2. While no female ticks were collected at Trios Tunnel, the number of nymphs ranged from 0-2 and for larvae 0-2. At Trios Tunnel, the number of nymphs was significantly higher during April and June but not for July and September. On the other hand, the number of larvae increased from July to November, while at Sidi Trad cave, female ticks were recovered during April and May and then disappeared until the end of the study period. Significant differences were noted during all the months when compared with all stages. Nymphs infested bats significantly during April and May, declined in June and July, and then became steady until October. Larvae peaked in July, with low frequency in April, and then fluctuated from August to November.

Facial myiasis and canthariasis associated with systemic lupus panniculitis: a case report.

BACKGROUND: Infestation of insects can cause myiasis due to dipetran larvae and canthariasis due to coleopteran larval or adult stages. OBJECTIVE: To report a case of facial myiasis and canthariasis in a patient known to have panniculitis due to systemic lupus erythematosus and autoimmune hemolytic anemia. METHOD: Larval and pupal stages of insects were recovered from the face of a patient, mounted, and identified. RESULT: Initially, the pupal stage of the common green bottle fly Lucilia sericata was extracted from the patient's face, treated, and then came back with secondary infestation caused by two species of beetles, the drugstore beetle, Stegobium paniceum, and a beetle of the genus Trogoderma. CONCLUSION: This is the first report on facial canthariasis due to larval stages caused by two species of beetles and recovery of pupal stages of the common green bottle fly.