Caracterização e distribuição espacial dos acidentes escorpiônicos em Belo Horizonte, Minas Gerais, 2005 a 2009

Abstract

Scorpionism is a public health problem in Belo Horizonte. There may be cases of death or temporary consequences. Its importance is increased by the urban occurrence and fatal outcome in pediatric patients. A retrospective epidemiological study was done to characterize scorpion sting accidents occurred in Belo Horizonte, between 2005 and 2009. The aim was also to study and associate the frequency and spatial distribution of scorpionism cases with the Health Vulnerability Index (IVS), and to characterize the profile of requests from residents about the appearance of scorpions in their buildings, relating it with the accidents profile. Notification data of scorpion sting accidents that occurred in Belo Horizonte were used from the National System of Notifiable Diseases (SINAN) and Epidemiological Surveillance System (SISVE) for the years 2008 and 2009. It was also used the clinical records of João XXIII Hospital (HPSJ XXIII), for the period between 2005 and 2007 and from residents requests forms about the appearance of scorpions in their buildings, obtained from the Municipal Health Secretariat (SMSA-BH). Data were organized into the Excel version 2003. For georeference and spatial analysis, geographic base EndGeo and features of the mapping application MapInfo version 10.0 were used. The programs Hotspot Detective and SatScan were used to apply the Technique of Kernel Density and Space-Time-Permutation test for clusters detection, respectively. Statistical analyses about other variables were made by the chi-square test. Between 2005 and 2009 occurred in Belo Horizonte 2769 cases of scorpionism, which represents an accumulated incidence of 114.7 cases per 100,000 inhabitants. There was a decreasing trend during the years and a higher rate of cases between August and January. The species Tityus serrulatus was responsible for most accidents. The scorpion sting accidents occurred more inside home, affecting mostly hands and feet of victims. There was no statistical difference between men and women affected (p> 0.05) and people aged between 55 and 64 years had a higher risk to scorpionism. Most of the cases were attended within one hour after the sting. Local symptoms were more frequent than systemic manifestations. Ninety-six percent of the patients achieved cure and there were two deaths of children aged 4 and 6 during the year of 2005 and 2009, respectively. Among 1924 (69.5%) georeferenced scorpionism cases, the highest incidence was observed in the Northwest Sanitary District (DS), followed by the Northeast DS. It was also observed large concentration of cases in the regions of the city cemeteries. Using the Technique of Kernel Density, there were concentrated points of scorpionism cases in the Northwest Sanitary District (DS)g, Northeast DS and West DS. It was also detected two clusters in the period, one in 2005, located in the Northwest and West DS, and another between 2006 and 2007 in the Northwest and Northeast DS. There was no association between higher incidence areas of scorpionism in Belo Horizonte and the areas of higher health risk classified by IVS. It is necessary to improve the reporting process and the information flow about the scorpion sting accidents. A higher mobilization and targeting of health services, mainly on priority areas, are suggested to improve the effectiveness of scorpionism surveillance and control strategies in Belo Horizonte.