Instituto de Saúde Coletiva, Universidade Federal da Bahia, Rua Basílio da Gama, s/n, Salvador, 40110-040, Brazil.
Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Largo do Terreiro de Jesus, s/n Centro Histórico, Salvador, 40026-010, Brazil.
Trans R Soc Trop Med Hyg. 2021 Sep 3;115(9):975-983. doi: 10.1093/trstmh/trab120.
Scorpion envenoming is relatively frequent in tropical and subtropical regions and potentially fatal. We aimed to identify risk factors for fatal scorpion envenoming among Brazilian children.
A case-control study investigated all fatal cases of scorpion envenoming among children up to 10 y old, reported to the Brazilian Diseases Surveillance System between 1 January 2007 and 18 July 2016. Controls were randomly sampled from children who survived the envenoming over this period. Data were analysed using logistic regression.
Of the 254 cases and 1083 controls investigated, the identified risk factors were age ≤5 y, occurred in a rural area, time-to-treatment ≥3 h, treatment with scorpion antivenom (SAV) but either excessive or insufficient number of vials, treatment with antivenom that was neither SAV nor anti-spider and no antivenom administered compared with the standard recommended treatment. Treatment effectiveness at preventing fatal scorpion envenoming was 77.0% when time-to-treatment was <3 h and 75% in children 9-10 y of age. SAV was 63% effective at preventing death when administered early at the recommended dosage.
Fatal scorpion envenoming was associated with younger age, incident occurring in a rural area, late treatment and inadequate antivenom treatment. SAV was effective at preventing death when administered early.
蝎子蜇伤在热带和亚热带地区较为常见，且可能致命。本研究旨在确定巴西儿童致命性蝎子蜇伤的危险因素。
采用病例对照研究，调查了 2007 年 1 月 1 日至 2016 年 7 月 18 日期间巴西疾病监测系统报告的所有 10 岁以下儿童致命性蝎子蜇伤病例。对照组为在此期间幸存下来的儿童。采用逻辑回归分析数据。
在 254 例病例和 1083 例对照中，确定的危险因素为年龄≤5 岁、发生在农村地区、治疗时间≥3 小时、使用了蝎毒抗血清（SAV）但使用的 SAV 剂量过多或过少、使用了非 SAV 或抗蜘蛛毒液且未使用抗蛇毒血清与标准推荐治疗方法相比。治疗时间<3 小时时，SAV 预防致命性蝎子蜇伤的有效性为 77.0%，9-10 岁儿童的有效性为 75%。早期给予推荐剂量的 SAV 治疗时，其预防死亡的有效性为 63%。
致命性蝎子蜇伤与年龄较小、发生在农村地区、治疗时间较晚以及抗蛇毒血清治疗不充分有关。早期给予 SAV 治疗可有效预防死亡。
