Favalesso Marília Melo, Valentim Matheus, Guimarães Ana Tereza Bittencourt, Peichoto Maria Elisa
Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Medicina Tropical (INMeT) - ANLIS "Dr. Carlos G. Malbrán". Almafuerte y Ámbar s/n, Puerto Iguazú, CP: 3370, Misiones, Argentina.
IT University of Copenhagen, Rued Langgaards Vej 7, København PO Box: 2300, Denmark.
Acta Trop. 2023 Feb;238:106777. doi: 10.1016/j.actatropica.2022.106777. Epub 2022 Dec 9.
Lonomism is the envenomation caused by accidental contact with Lonomia caterpillars, and this is a public health priority in South America since it is relatively common but remains underestimated. This study presents an updated and integrative analysis of reliable global data from 1960 to 2020 on the epidemiology of this envenomation in the whole continent. A total of 13,186 notifications were recorded for South America: 13,056 (99.01%) in Brazil, 49 (0.37%) in Argentina, 43 (0.33%) in Colombia, 29 (0.22%) in Venezuela, 6 (0.05%) in Peru and 3 (0.02%) in French Guiana. The number of new locations reporting accidents has increased since the first formally notifications at the middle of the last century. Most of these locations are situated in Brazil, the pioneer in deeply researching the Lonomia genus and its impacts in public health. Most victims were males, in the economically productive age group, and accidental contact occurred more frequently in the upper limbs while doing activities outdoors in urban/rural areas. Regarding the determinants of clinical outcome, countries where patients received delayed medical care were associated with a higher number of moderate and/or severe cases, as well as a higher chance of progressing to death. Additionally, the longer the delay for accessing medical care, the higher the risk of developing systemic complications, thereby increasing the need for specific treatment. Our study also shows that accidents globally occurred more frequently in the summer months and in the beginning of autumn. Although having identified several shortcomings in the documents selected and verified that notifications are strongly biased by public policies adopted by each South American country, this study provides the first comprehensive assessment of lonomism in South America, demonstrating the increase in the number of accidents, and their expansion to other areas of the continent over time. Our findings will undoubtedly help guide the appropriate allocation of resources and implementation of prevention strategies and define priority criteria for epidemiological surveillance of this neglected tropical disease.
绒刺蛾中毒是因意外接触绒刺蛾毛虫而导致的中毒现象，鉴于其相对常见但仍被低估，这在南美洲是一个公共卫生重点问题。本研究对1960年至2020年整个大陆关于这种中毒现象流行病学的可靠全球数据进行了更新和综合分析。南美洲共记录了13186起报告病例：巴西有13056起（99.01%），阿根廷有49起（0.37%），哥伦比亚有43起（0.33%），委内瑞拉有29起（0.22%），秘鲁有6起（0.05%），法属圭亚那有3起（0.02%）。自上世纪中叶首次正式报告以来，报告事故的新地点数量有所增加。这些地点大多位于巴西，巴西是深入研究绒刺蛾属及其对公共卫生影响的先驱。大多数受害者为男性，处于经济生产年龄组，在城市/农村地区户外进行活动时，上肢意外接触更为频繁。关于临床结果的决定因素，患者接受延迟医疗护理的国家，中度和/或重度病例数量较多，进展至死亡的可能性也较高。此外，获得医疗护理的延迟时间越长，发生全身并发症的风险越高，因此对特定治疗的需求也越大。我们的研究还表明，全球事故在夏季和初秋更为频繁。尽管已确定所选文件存在若干缺陷，并证实报告受到每个南美国家所采取公共政策的强烈影响，但本研究首次对南美洲的绒刺蛾中毒进行了全面评估，表明事故数量有所增加，且随着时间推移已扩展到该大陆的其他地区。我们的研究结果无疑将有助于指导资源的合理分配和预防策略的实施，并为这种被忽视的热带疾病的流行病学监测确定优先标准。
