Snakebites in the Municipality of Tarauacá, Acre, Western Brazilian Amazon

Authors

  • Clarine de Oliveira Saboia Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil
  • Paulo Sérgio Bernarde Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil

DOI:

https://doi.org/10.7322/jhgd.157760

Keywords:

ophidism, snakes, envenomations, venomous animals, epidemiology

Abstract

Introduction: Snakebites are a public health problem and are considered a common clinical emergency in several tropical countries, especially in rural and forested regions where these animals are more frequent. It is estimated that approximately 28,800 cases of snakebites per year occur in Brazil, with an average of 119 deaths, in which the north region has the highest rate of incidence. However, the accuracy of these data ends up being brought into question, since there are undoubtedly many cases of under-reporting and even cases that are not reported at all, due to logistical and geographical reasons or due to a lack of preparation as to the precise identification of the problem.

Objective: This study aimed to describe the epidemiological characteristics of the reported cases of snakebites victims in the municipality of Tarauacá (Acre), comparing the morbidity coefficient with other Amazonian regions, and to observe possible factors associated with the appearance of complications in these cases.

Methods: This is a retrospective descriptive study through the analysis of the clinical-epidemiological information found on the notification sheets of the Information System of Notification Diseases of victims of snakebites that occurred during the period between 2012 and 2016 in Tarauacá.

Results: We recorded 96 snakebite cases during the study period, with the majority (95.8%) classified as botropic, followed by laquetics (3.2%) and one by a non-venomous snake (1%). No deaths were recorded. Snakebites were more frequent in rural areas (87.5%), most being an occupational accident, and affected mainly adult male individuals in their lower limbs. Most cases occurred during the rainy season and had a positive correlation with rainfall.

Conclusions: The morbidity coefficient registered in Tarauacá in 2016 (72.5 cases per 100,000 inhabitants) was higher than that recorded in the cities of Cruzeiro do Sul and Rio Branco and in the states of Acre and Amazonas. Although most patients receive antivenom within the first six hours, many victims do not receive appropriate hospital care until more than 24 hours after the envenoming, which is a factor associated with the appearance of complications.

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Author Biographies

  • Clarine de Oliveira Saboia, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil

    Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta

  • Paulo Sérgio Bernarde, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil

    Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta

References

1. Chippaux JP. Estimating the global burden of snakebite can help to improve management. PLoS Med. 2008;5(11):e221. DOI: https://dx.doi.org/10.1371/journal.pmed.0050221

2. Silva AM, Bernarde PS, Abreu LC. Accidents with poisonous animals in Brazil by age and sex. J Hum Growth Dev. 2015;25(1):54-62. DOI: http://dx.doi.org/10.7322/jhgd.96768

3. Bochner R, Struchiner CJ. Acidentes por animais peçonhentos e sistemas nacionais de informação. Cad Saúde Pública. 2002;18(3):735-46. DOI: http://dx.doi.org/10.1590/S0102-311X2002000300017

4. Albuquerque HN, Costa TBG, Cavalcanti MLF. Estudo dos acidentes ofídicos provocados por serpentes do gênero Bothrops notificados no estado da Paraíba. Rev Biol Ciênc Terra. 2005;5(1):1-7.

5. Bernarde PS. Ofidismo no Estado do Acre - Brasil. J Amazon Health Sci. 2015;1(2):44-63.

6. Pierini SV, Warell DA, Paulo A, Theakston RDG. High incidence of bites and stings by snakes and other animals among rubber tappers and amazonian indians of the Juruá Valley, Acre state, Brazil. Toxicon. 1996;34(2):225-36.

7. Bernarde PS, Gomes JO. Serpentes peçonhentas e ofidismo em Cruzeiro do Sul, Alto Juruá, Estado do Acre, Brasil. Acta Amaz. 2012;42(1):65-72. DOI: http://dx.doi.org/10.1590/S0044-59672012000100008

8. Moreno E, Queiroz-Andrade M, Lira-da-Silva RM, Tavares-Neto J. Características clínico epidemiológicas dos acidentes ofídicos em Rio Branco, Acre. Rev Soc Bras Med Trop. 2005;38(1):15-21. DOI: http://dx.doi.org/10.1590/S0037-86822005000100004

9. Bochner R, Struchiner CJ. Epidemiologia dos acidentes ofídicos nos últimos 100 anos no Brasil: uma revisão. Cad Saúde Pública. 2003;19(1):7-16. DOI: http://dx.doi.org/10.1590/S0102-311X2003000100002

10. Waldez F, Vogt RC. Aspectos ecológicos e epidemiológicos de acidentes ofídicos em comunidades ribeirinhas do baixo rio Purus, Amazonas, Brasil. Acta Amaz. 2009;39(3):681-92. DOI: http://dx.doi.org/10.1590/S0044-59672009000300025

11. Instituto Brasileiro de Geografia e Estatística (IBGE). Censo demográfico, 2017. [cited 2018 Fev 22] Available from: https://cidades.ibge.gov.br/brasil/ac/rio-branco/pesquisa/53/49645?ano=2017

12. Base de Dados da Pesquisa Agropecuária (BDPA). Programa Estadual de Zoneamento Ecológico - Econômico do Estado do Acre Fase II: Escala 1:250.000. 2 ed. Rio Branco: SEMA, 2010.

13. Instituto Nacional de Meteorologia (INMET). Climatologia. [cited 2017 Oct 15] Available from: http://www. inmet.gov.br/portal/index.php?r=clima/normaisClimatologicas

14. JMP®. 1989 - 2013. Version 10. SAS Institute Inc., Cary: 2013.

15. Chippaux JP. Epidemiology of envenomations by terrestrial venomous animals in Brazil based on case reporting: from obvious facts to contingencies. J Venom Anim Toxins Incl Trop Dis. 2015;21:13. DOI: http://dx.doi.org/10.1186/s40409-015-0011-1

16. Feitosa ES, Sampario V, Sachett J, Castro DB, Noronha MDN, Lozano JLL, et al. Snakebites as a largely neglected problem in the Brazilian Amazon: highlights of the epidemiological trends in the State of Amazonas. Rev Soc Bras Med Trop. 2015;48(suppl.1):34-41. DOI: http://dx.doi.org/10.1590/0037-8682-0105-2013

17. Oliveira ME, Martins M. When and where to find a pitviper: activity patterns and habitat use of the lancehead, Bothrops atrox, in central Amazonia, Brazil. Herpetol Nat Hist. 2002;8(2):101-10.

18. Turci LCB, Albuquerque S, Bernarde PS, Miranda DB. Uso do hábitat, atividade e comportamento de Bothriopsis bilineatus e de Bothrops atrox (Serpentes: Viperidae) na floresta do Rio Moa, Acre, Brasil. Biota Neotrop. 2009;9(3):197-206. DOI: http://dx.doi.org/10.1590/S1676-06032009000300020

19. Risk JY, Cardoso JLC, Sueiro LR, Santos SMA. Acidentes com cobras-corais e o Instituto Butantan. In: Silva Jr NJ. As cobras-corais do Brasil: Biologia, Taxonomia, Venenos e Envenenamentos. Goiás: PUC, 2016.

20. Martins M, Oliveira ME. Natural history of snakes in forests of the Manaus region, Central Amazonia, Brazil. Herpetol Nat Hist. 1998;6(2):78-150.

21. Nascimento SP. Aspectos epidemiológicos dos acidentes ofídicos ocorridos no Estado de Roraima, Brasil, entre 1992 e 1998. Cad Saúde Pública. 2000;16(1):271-6. DOI: http://dx.doi.org/10.1590/S0102-311X2000000100031

22. Otero R, Gutiérrez JM, Núnez V, Robles A, Estrada R, Segura E, et al. A randomized double-blind clinical trial of two antivenoms in patients bitten by Bothrops atrox in Colombia. Trans R Soc Trop Med Hyg. 1996;90(6):696-700. DOI: https://dx.doi.org/10.1016/S0035-9203(96)90442-3

23. Pardal PP, Souza SM, Monteiro MR, Fan HW, Cardoso JL, França FO, et al. Clinical trial of two antivenoms for the treatment of Bothrops and Lachesis bites in the north eastern Amazon region of Brazil. Trans R Soc Trop Med Hyg. 2004;98(1):28-42. DOI: https://dx.doi.org/10.1016/S0035-9203(03)00005-1

24. Smalligan R, Cole J, Brito N, Laing GD, Mertz BL, Manock S, et al. Crotaline snake bite in the Ecuadorian Amazon: randomised double blind comparative trial of three South American polyspecific antivenoms. BMJ. 2004;329(7475):1129. DOI: https://dx.doi.org/10.1136/bmj.329.7475

25. França FOS, Málaque CMS. Acidente botrópico. In: Cardoso JLC, França FOS, Wen FH, Málaque CMS, Haddad Jr. V. Animais peçonhentos no Brasil: Biologia, clínica e terapêutica dos acidentes. 2ed. São Paulo: Sarvier, 2009; p. 81-95.

26. Núñez V, Cid P, Sanz L, De la Torre P, Angulo Y, Lomonte B, et al. Snake venomics and antivenomics of Bothrops atrox venoms from Colombia and the Amazon regions of Brazil, Perú and Ecuador suggest the occurrence of geographic variation of venom phenotype by a trend towards paedomorphism. J Proteomics. 2009;73(1):57-78. DOI: https://dx.doi.org/10.1016/j.jprot.2009.07.013

27. Bezerra IMP, Sorpreso ICE. Concepts and movements in health promotion to guide educational practices. J Hum Growth Dev. 2016; 26(1):11-20. DOI: http://dx.doi.org/10.7322/jhgd.113709

28. Bernarde PS, Cossta JG, Dutra JS, Silva MS, Silva FVA. Ações educativas sobre primeiros socorros e prevenção de acidentes ofídicos no Alto Juruá (AC). South Am J Bas Educ Tech Technol. 2018; 5(2):289-299.

Published

2019-05-06

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Section

Artigos Originais