Protocol of care for the management of scorpionism created in Venomous Animal Accident Care Reference Service in a region with high prevalence of cases

Abstract

 The general objective of this protocol was to describe the epidemiological profile of scorpion cases in the municipality of Teófilo Otoni (MG) and, based on this, assess the need to implement a service protocol directed to the region. It was also our objective: to describe the prevalence of scorpion cases recorded by the Accident Care Reference Service by Venomous Animals in the municipality of Teófilo Otoni in the period from 2013 to 2023. From this, we compile and list the data, assessing the need to create a care protocol aimed at mild, moderate and severe cases. The following were included cases of scorpionism notified at the Reference Service for Assistance to Accidents by Venomous Animals of Teófilo Otoni from 2013 to 2023, including data from the notification form used in the service, such as age group, gender, education, location of the bite, case classification, serum therapy, time of care and evolution of the case. Cases of scorpionism with incomplete notification records (missing information above) at the Teófilo Otoni reference service and from 2014 to 2024 were left out of this study. The survey did not offer risks of direct identification to those notified. The benefits for the research subjects are indirect, since the data obtained during the study will contribute to the construction of relevant scientific evidence, capable of supporting public policies and intervention strategies aimed at public health promotion and prevention. 

 Scorpionism is the poisoning caused by the inoculation of venom through the stinger of a scorpion, an arachnid common in tropical and subtropical regions, especially during periods of greater heat and humidity. In Brazil, the scorpions of public health importance are of the species of the genus Tityus (Tityus serrulatus, Tityus bahiensis, Tityus stigmurus and Tityus obscurus), with T. serrulatus (popularly known as yellow scorpion) being the one with the highest potential for envenomation severity. Children and the elderly are the groups most vulnerable to severity, with mortality of up to 70%.1,2 The expansion of urban areas, combined with the lack of basic sanitation infrastructure and the insufficiency of decent housing, contributes to the emergence of conditions conducive to the increase of the scorpion population.3 The scorpion of the genus Tityus, especially T. serrulatus, is a nocturnal and solitary animal that hides during the day in damp and dark places, such as cracks in walls, rubble and garbage. Its diet is made up of small insects and arthropods, and it can survive for long periods without feeding, due to its low metabolism. Adapted to the urban environment, T. serrulatus lives in areas with a large human concentration, such as houses and schools, where it finds shelter and food. It prefers dry environments protected from light, with mild temperatures and controlled humidity.1 Surveillance of scorpion accidents is carried out by registering in the Ministry of Health database in the Information System for Diseases and Notifications (SINAN). Through it, it is mandatory to report all cases of accidents by venomous animals, providing access to information to support public health agencies in the distribution of serum and in the care of accident victims, as well as in the direction of strategies to combat and prevent accidents.4 The northeast macro-region of the state of Minas Gerais is composed of 86 municipalities distributed.