Epidemiological, clinical, biological and evolutionary profile of scorpion envenomed children under one year to 15 years in the Souss Massa region of Morocco.

Morocco is one of the main countries affected in North African with the scorpion envenomations. Faced with the threat, significant morbidity and a major risk of death especially in children, a detailed identification of scorpionic profile of stings remains important for health authorities at national or even regional level. The current study aims to establish the epidemiological, clinical, biological and evolutionary data of the scorpionism by analyzing 383 cases of scorpion stings in children from three age groups (<1 year, 1-5 years and >5 years), admitted at the Regional Hospital Hassan II-Agadir in the Souss Massa region during the period of 9 years and 10 months from January 2013 to October 2022. Our results showed that patients under 1 year of age presented the most severe cases and had the highest mortality rate. However, the clinical signs and symptoms observed illustrated severe damages to vital systems, particularly the cardiovascular, neurological and pulmonary systems, although the signs associated with the latter were present only in cases admitted in grades 2 and 3 for the three age categories studied. Fluctuations in vital constants (temperature and peripheral oxygen saturation, blood pressure, heart rate and respiratory rate), biochemical parameters (ASAT, ALAT, urea and blood creatine, as well as blood sugar) and CBC results revealed major functional disturbances in vital organs, especially in envenomated cases admitted in grade 3. A positive correlation was mentioned between the state of evolution and the various epidemiological parameters, digestive symptoms, as well as signs and symptoms linked to hemodynamic state, general and neurological state. The main interest is to illustrate the seriousness of scorpion envenomations, especially in the high-risk population, for whom an improved therapeutic approach in health centers will undoubtedly be reinforced, and the admission of immunotherapy, as a fundamental part of the treatment, remains important.

Clinical, epidemiological and faunistic characterization of scorpionism in Azilal, Central High Atlas (Morocco).

The province of Azilal is one of the most scorpion-infested areas in Morocco. The current study aims to investigate the clinical and epidemiological characteristics of scorpion envenomation in the Azilal province, as well as to contribute to the study of its scorpio-faunistic diversity. We examined clinical and epidemiological data from 5684 scorpion stings recorded between 2017 and 2021. Prospections on the ground were carried out in the study area. The species were identified using the taxonomic keys. Distribution maps of inventoried species have been created using SIG. 5684 scorpions stings were reported in the study area, with 18 cases of deaths. Most of the cases was reported in the summer especially at night (64%). A positive significant correlation was found between scorpion stings incidence and season (P < 0.005; r = 0.56). A positive correlation was found between scorpion stings incidence and mortality (r = 0.09). Pediatric mortality was higher compared to lethality in adults (P < 0.05). A positive correlation was found between the number of stung children (Age <15 years) and the number of patients presenting clinical signs of severe envenomation (Class III) (r = 0.40). The percentage of patients that use traditional remedies was significantly higher in the rural areas (P < 0.05). Most scorpion stings occurred in human habitat (54.5%) or in their neighbourhood (24.5%). Six species were identified in the study area. The findings of this study have highlighted the extent of scorpion envenomation and have elucidated certain characteristics of the scorpio-faunistic biodiversity in the Azilal province.

Epidemiological, toxicological and physiopathological characteristics of scorpion stings and their management in Morocco: A literature review.

All around the world, scorpion envenomation represents a public health issue. In Morocco, it represents the first cause of poisoning. The aim of this review is to highlight the epidemiological, toxicological and physiopathological characteristics of scorpion stings and envenomation in Morocco as well as their management. According to the bibliography, the most areas affected by scorpion stings and envenomation are those in the center and south of Morocco. Lethality rate is more important in children than adult. Age, admission class, season, serum venom concentration, and the time elapsed between the scorpion sting and medical intervention are risk factors for a poor prognosis. Until now, we have only known the LD50 of 14 scorpion species from three genera: Androctonus, Buthus and Hottentota, and only 6 species, out of 61 moroccan scorpions, have been assessed for their venom toxicity on mice organs. The venom of harmful moroccan scorpions induces several histopathological changes in the myocardium, brain, liver, pulmonary alveoli, and kidneys in rats, as well as severe consequences in the lungs with intra-alveolar hemorrhage. There was also a significant increase in serum enzyme levels of aspartate transaminase (AST), alanine transaminase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), as well as high levels of plasma albumin, creatine and glucose. In the absence of a specific treatment, the management of scorpion envenomation is based only on symptomatic therapy. We noted a widely use of traditional remedies. Despite the magnitude of the scorpion problem in Morocco, it remains understudied and continues to claim lives, particularly given the lack of an efficient etiological cure.