SnakebiteThe first estimate of cases of, and deaths from, snakebite in the world was undertaken in 1954 by Swaroop and Grab. They presented a range between 30,000 and 40,000 annual deaths globally (without including the Soviet Bloc, China or the countries of Central Europe). Within this total, the largest figures were for Asia (25,000 to 35,000) and South America (3,000 to 4,000). For Africa, the authors explained that calculation was difficult and ended up estimating the number of deaths as between 400 and 1,000. In regard to the total number of global cases, they admitted that estimation was difficult, but hazarded an initial guess of around half a million people annually bitten by both poisonous and non-poisonous snakes.
Note: Citations are based on reference standards. However, formatting rules can vary widely between applications and fields of interest or study. The specific requirements or preferences of your reviewing publisher, classroom teacher, institution or organization should be applied. Epidemiologia e saude 7 edicao pdf download. Ava software private ltd. Greek letter with 4 letters. Manly p hall collected writings. Cara download aplikasi.
In 1982, a study stated that the worldwide total number of snakebites was difficult to estimate. Nonetheless, the author predicted around 4 to 5 million accidents, and probably more than 150,000 deaths. Such predictions were made based on previous research ,. The study provided a map with snakebite morbidity per 100,000 inhabitants (shown in Figure ) and informed that its source was a work of the World Health Organization. When this reference was analyzed, neither this map was found nor the snakebite morbidity represented there. The same article – based on two chapters of the same book and two articles – also estimated the incidence of snakebites in Central and South America (with an estimated population of 400 million) as at least 300,000 cases with a total of 150,000 recorded every year, of which 65% receive hospital treatment.
According to that study, the number of deaths from snakebite in the entire world exceeds 5,000 and their distribution is probably uneven. Figure reproduces a map that displays the global distribution of snakebite morbidity which was excerpted from that work.
It is of interest to observe that the data presented in this graphic do not correspond with the data contained in the same article in reference to Central and South America, as well as for Brazil as a whole. A similar map with the global incidence of snakebite envenomations per 100,000 inhabitants was published by Chippaux and Goyffon in 2006 and by Chippaux in 2008 and 2009. The map is reproduced in Figure, in which Brazil is categorized using the same color as the majority of African countries.
The result is that Brazil is presented as having the same incidence of the continent in which the snakebite rate is more than 100 per 100,000 inhabitants. Despite the fact that the map appears in four articles, only Chippaux offers any indication of the reference bases used to generate the estimates, although with no explanation of how this was done ,. The maps that Kasturiratne et al. Present display minimum values of cases and deaths for snakebites. These are reproduced in Figures and, respectively.
By not taking into account country populations, and consequently being able to calculate the number of incidents per 100,000 inhabitants, the possibility of undertaking comparative analyses among regions and the various estimates becomes more difficult. According to these maps, Brazil is classified into the category that encompasses 10,001 to 100,000 cases and 101 to 1,000 deaths, figures which are much less clarifying than those presented earlier, and which are derived from the authors’ very own tables. This being the case, the relevance and pertinence of these maps should be questioned, since they do not faithfully represent the data presented in the same article.
Chippaux and Goyffon suggested that scorpions are found abundantly in tropical regions, especially in humid locations of hot subdesert zones. So, they showed that the morbidity and mortality from scorpion bites were particularly higher in Central America, North Africa and the Middle East. Their work included a map showing the global incidence of scorpion envenoming, reproduced in Figure. How such estimates were obtained is not informed, and the references did not include any article dealing with scorpionism in Brazil. In 2008 Chippaux and Goyffon reviewed the literature of the last 30 years in order to discuss the global epidemiology of scorpion bites. They published a map showing the annual incidence of scorpion bites per 100,000 inhabitants, which is reproduced in Figure. This same map was also used in three articles by Chippaux published in 2008 and 2009, as well as in his presentation delivered in 2013 at the 1st International Conference Vital for Brasil.
It is interesting to observe how the estimates for Brazil changed by comparing Figures and and, although the authors are practically the same, there is no mention regarding these changes. Figure, on the other hand, has remained the same since 2008, which is puzzling, given the changes which have taken place in Brazil with regard to increased populations of both humans and scorpions. The estimates of the incidence of snake and scorpion envenoming in Brazil made by foreigners have shown themselves to be unsatisfactory and not a faithful reflection of the reality in the country.Very often, due to the fact that data are presented in maps, the discrepancies have gone unnoticed and have been reproduced over time in various publications.The methodology of developing indicators based on different regional studies is highly sensitive to the choice of works to be included in the sample.
In many cases the estimates are based on very heterogeneous data collected from highly specific locations, which generates unrepresentative and untrustworthy information. It is thus very necessary to be familiar with the peculiarities of Brazil, which is not an easy task, even for a native.Brazil has a long tradition in the production, control and distribution of antivenom serum, as well as in the free treatment of victims. A concern in regard to information about envenoming has been present in Brazil ever since the first ampoule of serum was delivered to the populace by Vital Brazil in 1901.Currently, the duty of reporting poisoning occurrences has changed from being obligatory to being compulsory. The records of these reports are the basis of the Information System on Diseases of Compulsory Declaration (SINAN), and, despite the possibility of underreporting in some geographic areas; these records constitute the best picture of the Brazilian reality in regard to envenoming.
Thus, the best course is to leave estimates to one side and to undertake research at national and regional levels, based on concrete data from the country as a whole, its states and municipalities. Such data have been available on the Internet since 2001. Supplementary material.