Department of International Health, School of Nursing and Health Studies, Georgetown University, Washington, DC 20057, USA.
Institute of Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro 21941-598, RJ, Brazil.
Int J Environ Res Public Health. 2021 Sep 5;18(17):9365. doi: 10.3390/ijerph18179365.
Animal stings are environmental hazards that threaten millions annually and cause a significant socioeconomic impact. Snakebite envenoming affects 2.7 million people globally every year, mostly the poorest and rural communities, with approximately 27,000 annual cases in Brazil. This study's objective is to identify the most exposed racial group for snakebites in rural areas of Brazil and analyze possible differences in the outcome of an accident. A retrospective epidemiological study was conducted using a database of rural snakebite cases from Brazil's Ministry of Health (2017). Descriptive analysis and a regression model were performed to examine the association of bad outcomes after a snakebite with several covariables. While mixed-race individuals presented the highest number of cases (61.79%), indigenous and white populations were the racial groups with the highest and lowest exposure rates (194.3 and 34.1 per 100,000 population, respectively). The fatality rate was 3.5 times higher in the indigenous population compared to the white population. In the multivariable model, the number of hours between the accident and health care received and the case classification suggested an association with a bad outcome. Snakebite is prominent in Brazil, particularly among indigenous groups. Antivenom is available in the Brazilian Health System; however, efforts need to be made for decentralization.
动物蜇伤是一种环境危害，每年威胁着数百万人的生命安全，并造成重大的社会经济影响。全球每年有 270 万人被蛇咬伤，其中大多数是最贫困和农村社区的人，而巴西每年约有 27000 例病例。本研究的目的是确定巴西农村地区最易受蛇咬伤影响的种族群体，并分析事故结果可能存在的差异。本研究使用巴西卫生部农村蛇咬伤病例数据库进行了回顾性流行病学研究（2017 年）。采用描述性分析和回归模型来检验蛇咬伤不良后果与多个协变量之间的关联。虽然混血儿的病例数量最多（61.79%），但土著和白人人口是暴露率最高和最低的种族群体（分别为每 10 万人 194.3 和 34.1 例）。与白人相比，土著人口的死亡率高 3.5 倍。在多变量模型中，事故发生与接受医疗护理之间的时间以及病例分类与不良结果之间存在关联。蛇伤在巴西很常见，尤其是在土著群体中。抗蛇毒血清可在巴西卫生系统中获得，但需要努力实现去中心化。
