Venomous animals in Pernambuco: children at risk

a cross-sectional study with an analytical component using secondary data from Centro de Informação e Assistência Toxicológica de Pernambuco (CIATox-PE), (Poison Center in Pernambuco)), in 2017 to 2019. Notifications of accidents caused were included in the studied age group and evaluated the characteristics of poisoning (animal classification, exposure zone, place and time of the occurrence and specific use of serum therapy), and of the patient (sociodemographic variables, clinical condition and evolution). The analysis performed in STATA® 13.1 presents frequency distribution tables and Pearson’s chi-square for comparison.

Results:

of the 2678 notifications, 82,8% were scorpionism and 10, 8% snakebite. The age group of1 to 9 years old (70.5%) and being male (54.1%) were predominant. Most of the cases occurred in urban area (80.9%), in Recife (67.3%), inside the victim’s residence (83.9%) and at night (47.3%). The majority (87.1%) were classified as ‘mild severity’, 10% received antivenom therapy and one died (by scorpionism). Two cases of snakebite in the workplace were registered.

Conclusion:

there was a high frequency of accidents caused in the urban area, which may be related to the lack of urban planning and sanitary education. The accidents caused among children in the household environment and the suspicion of child labor in the age group of 10 to 14 years old were also highlighted which favors the development and habits of the venomous animal.

Key words
Envenoming; Animals venomous; Pediatrics; Epidemiology; Snake bites; Scorpion stings

Variables	N	%
Year of notification
2017	792	29.6
2018	963	36.0
2019	923	34.4

Age group (years)
<1	82	3.1
01 - 04	922	34.4
05 - 09	966	36.1
10 - 14	708	26.4

Sex
Male	1449	54.1
Female	1229	45.9

Exposure zone
Urban	2167	80.9
Rural	393	14.7
Unknown	118	4.4

Exposure location
Usual residence	2248	83.9
Another residence	30	1.1
Outdoors/public	156	5.8
School or daycare	18	0.7
Workplace	2	0.1
Other places	3	0.1
Unknown	221	8.3

Time of exposition
00:00a.m. - 05:59a.m.	155	5.8
06:00a.m. - 11:59a.m.	524	19.6
12:00p.m. - 5 :59p.m.	732	27.3
6 :00p.m. - 11:59p.m.	1267	47.3

Animal classification
Scorpion	2.216	82.7
Snake	288	10.8
Spider	46	1.7
Lepidopteran^* * Lepidopteran (caterpillars), Hymenopter (stinging insects, wasps, bees).	45	1.7
Hymenopteran^* * Lepidopteran (caterpillars), Hymenopter (stinging insects, wasps, bees).	35	1.3
Aquatic animal	19	0.7
Other animals	29	1.1

Time elapsed between the accident and the assistance at then health services
Up to 1 hour	1.843	68.8
> 1 hour	830	31.0
Unknown	5	0.2

Severity classification
Mild	2.332	87.1
Moderated	300	11.2
Severe	43	1.6
Null	3	0.1

Hospitalization
Yes	2.076	77.5
No	509	19.0
Follow-up lost	83	3.1

Poisoning treatment
Serum therapy	268	10.0
- Anti scorpion	148
- Anti snakebite	120

Outcome
Cure	2.499	93.0
Death	1	0.4
Follow up losts	178	6.6

Variables	Age group (years)
	<1		01 to 04		05 to 09		10 to 14		p
	n	%	n	%	n	%	n	%	p
	82	3.1	922	34.4	966	36.1	708	26.4
Animal classification^* * Lepidopteran (caterpillars), Hymenopter (stinging insects, wasps, bees).									<0.001
Scorpion	63	76.8	815	88.4	803	83.3	535	75.6
Snake	5	6.1	43	4.7	112	11.6	128	18.1
Spider	6	7.3	15	1.6	9	0.9	16	2.3
Lepidopteran^ * Lepidopteran (caterpillars), Hymenopter (stinging insects, wasps, bees).*	2	2.4	21	2.3	15	1.6	7	1.0
Hymenopteran^ * Lepidopteran (caterpillars), Hymenopter (stinging insects, wasps, bees).*	4	4.9	7	0.8	14	1.5	10	1.4
Aquatic animal	1	1.2	4	0.4	5	0.5	9	1.3
Other animals	1	1.2	17	1.8	8	0.8	3	0.4

Sex									0.188
Male	50	61.0	512	55.5	499	51.7	388	54.8
Female	32	39.0	410	44.5	467	48.3	320	45.2

Exposure location									<0.001
Usual residence	78	95.1	802	87.0	640	83.1	565	79.8
Other places	4	4.9	120	13.0	163	16.9	143	20.2

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
E-mail: revista@imip.org.br

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[1] Author’s contribution

Albuquerque MCA, Amorim MLP, Mello MJG, Lyra Filho CRN participated in the study design and planning; acquisition, analysis and interpretation of data, as well as in the writing and elaboration of the article, and in the critical intellectual review. Lins IBL, Lima PVC participated in data acquisition and analysis, as well as critical intellectual review. All authors approved the final version of the manuscript. The authors declare no conflict of interest.