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在热带稀树草原地区,蝎子螫伤:环境预测因子和生命损失年数。

Scorpion envenomation in the neotropical savannah: Environmental predictors and years of lost life.

机构信息

Biological Sciences and Health Centre, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil.

Federal University of Triangulo Mineiro, Uberaba, Minas Gerais, Brazil; Graduate Program in Entomology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.

出版信息

Toxicon. 2023 Oct;234:107277. doi: 10.1016/j.toxicon.2023.107277. Epub 2023 Sep 1.

Abstract

Scorpion stings envenomation (SSE) is a growing medical concern in Brazil, particularly in the state of Minas Gerais, which has recorded a significant number of incidents. This study aimed to investigate the potential predictors of scorpion sting incidence and evaluate the cost-effectiveness of interventions in Minas Gerais. Generalized Estimating Equations (GEE) models were constructed using socioeconomic and environmental variables as predictors and scorpion sting incidence as the response variable. The analysis revealed that mean annual temperature and major land use type were significant predictors of scorpion sting incidence, while precipitation and socioeconomic variables showed no relationship with incidence. The total number of cases and annual incidence of scorpion stings overlapped with regions experiencing higher forest conversion and agricultural land use, as well as higher temperatures. The estimated Disability-Adjusted Life Years (DALY) for scorpion sting incidents in Minas Gerais was substantial, indicating the need for effective prevention and treatment measures. The cost per DALY averted varied among municipalities, with some requiring minimal investment while others needing significant funding to address the scorpion risk. Mean annual temperature emerged as the main risk factor for scorpion stings, contributing to increased costs associated with antivenom treatment. These findings highlight the importance of considering environmental factors and implementing targeted interventions to mitigate scorpion sting incidents and reduce associated morbidity and mortality.

摘要

蝎子蜇伤(SSE)在巴西是一个日益严重的医学问题,特别是在米纳斯吉拉斯州,该州记录了大量的事件。本研究旨在调查蝎子蜇伤发生率的潜在预测因素,并评估米纳斯吉拉斯州干预措施的成本效益。使用社会经济和环境变量作为预测因子,使用广义估计方程(GEE)模型构建了蝎子蜇伤发生率作为反应变量的模型。分析表明,年平均温度和主要土地利用类型是蝎子蜇伤发生率的重要预测因子,而降水和社会经济变量与发生率无关。蝎子蜇伤的总病例数和年发生率与经历较高森林转化和农业土地利用以及较高温度的地区重叠。米纳斯吉拉斯州蝎子蜇伤事件的估计残疾调整生命年(DALY)很大,表明需要采取有效的预防和治疗措施。每个避免的 DALY 的成本在各城市之间有所不同,一些城市需要最小的投资,而其他城市则需要大量资金来解决蝎子风险。年平均温度是蝎子蜇伤的主要危险因素,导致抗蛇毒血清治疗相关成本增加。这些发现强调了考虑环境因素和实施有针对性的干预措施以减轻蝎子蜇伤事件并降低相关发病率和死亡率的重要性。

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