•Arch Hyg Sci 2017;6(2): 145-151 RESEARCH ARTICLE •Journal Homepage: http://jhygiene.muq.ac.ir Epidemiologic Status of Scorpion Sting in Qom, Iran 2004-2013 Abedin Saghafipoura*, Nahid Jesrib, Mehdi Noroozic, Reza Mostafavid aDepartment of Public Health, School of Health, Qom University of Medical Sciences, Qom, Iran. bResearch Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran cSubstance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. dQom Provincial Health Center, Qom University of Medical Sciences, Qom, Iran. *Correspondence should be addressed to Mr. Abedin Saghafipour, Email: [email protected] A-R-T-I-C-L-EI-N-F-O A-B-S-T-R-A-C-T Article Notes: Background & Aims of the Study: In the tropical regions of Iran, scorpionism is one of the Received: Oct. 10, 2016 important medical and public concerns. Poisoning with scorpion sting is one of the life threatening medical emergencies especially in individuals who are less than 6 years; knowing Received in revised form: about its epidemiologic aspects might lead to exploit appropriate preventive methods. Therefore, Nov. 20, 2016 for this purpose, the epidemiologic status of scorpion sting in Qom province of Iran was studied Accepted: Feb. 22, 2017 during 2004–2013. Available Online: Feb 28, Materials & Methods: This research is a descriptive-cross sectional study which has been done 2017 in all urban and rural areas of Qom province during 2004-2013 and all cases that referred to the one hospital, were assessed, examined, treated, followed and finally a questionnaire which is including demographic, epidemiologic and clinical data was completed for the patients. Data Keywords: were analyzed by SPSS 17. Chi square and Fisher’s exact test were used for the evaluation of the Scorpion sting hypothesis. Epidemiology Results: Totally, 395 cases of scorpion sting who were referred during the studied period. Most Qom of them had 10–24 years. Most of them were male (60.25%). The most cases occurred during Iran spring and summer. The stings mainly occurred at night between 22 p.m. and 4 a.m. Hands and foots were the most common organs of scorpion sting. 18.7 % of envenomed cases were due to black scorpion. 74.4 % of cases were from rural and 25.6 % from urban regions. 77.2% of the sufferers, sleep outdoor and on the floor. In 20.5% of cases, were surrounded by timber, dust and building materials. All cases have been received treatment and healed. Conclusions: Based on findings, scorpion sting is considered a public health concerns in Qom province. So, it seems the programs of health education on personal protection to prevent possible damages with scorpions, especially students to be necessary. Also, the villager's should use the proper bed to sleep outdoor before wearing clothes or shoes and before entering the bed Downloaded from jhygiene.muq.ac.ir at 23:08 IRST on Friday December 14th 2018 to ensure there are no scorpions. People should refuse to keep away timber, dust from residential environments for a long time. Please cite this article as: Saghafipour A, Jesri N, Noroozi M, Mostafavi R. Epidemiologic Status of Scorpion Sting in Qom, Iran 2004-2013. Arch Hyg Sci 2017;6(2):145-151. scorpions accidentally. Scorpions hide inside Background clothes or shoes incidentally and sting individuals when putting them on (1). Scorpions are dangerous arthropods subsisting Scorpionism (being stung by scorpions) is one from late Silurian period (i.e about 330 million of the most important health problems in years ago). Scorpions are carnivorous and feed developing countries in tropical and subtropical on insects, worms, arthropods, lizards or even regions that causes extensive side effects from small rodents. They are nocturnal and leave severe local dermal reactions to neurological, their hideouts with darkening of air searching cardiovascular, respiratory disorders and in for food and prey. Humans are stung by some cases death. Today, Scorpionism is an ---------------------------------------------------------------------------------------------------------------------------------------- Archives of Hygiene Sciences Volume 6, Number 2, Spring 2017 © 2017 Publisher: Research Center for Environmental Pollutants, Qom University of Medical Sciences. All rights reserved. 145 Saghafipour A, et al. / Arch Hyg Sci 2017;6(2): 145-151 •Epidemiologic Status of Scorpion Sting ... important health problem in some areas of dangerous scorpion species. The highest rate of world including countries which are located in scorpionismin of Iran especially in Khuzestan southern parts of Africa and Middle East such province is caused by this species (11-14). For as Algeria, Egypt, Iraq, Iran, Jordan, Morocco, many years, Iran’s researchers such as Dr. Sudan, South Africa and Mexico, Brazil, Farzanpey and colleagues had directed Argentina, Venezuela, Guyana, Trinidad in numerous studies as in thesis and research South America (2,3,4). Based on statistical projects to identify scorpion species of different data, about 1.2 billion people live in areas regions in Iran in which faunistic studies of having liability to be afflicted by scorpion sting scorpions in Iilam, Sari, Yazd, Shiraz, some and 1.2 million people are suffered by parts of Persian gulf islands and many other envenomation caused by scorpion venoms that regions could be mentioned (14-18). So far, causes mortality at a rate of 0.27% of stung Odonthobuthus doriae and Androctonus cases annually (5). This health problem causes crassicauda species have been reported from relatively high economic expanses and various Qom province (19). Scorpionism is happened in psycho-mental disorders in societies (4). many regions of Iran. More than 100,000 Scorpionism is occurred in many countries as in individuals are subjected to envenomation Morocco and Brazil, about 40,000 and 7,000 caused by scorpion sting annually in which annual cases of scorpion sting are reported, only about 36,000 cases are reported by respectively. From the total number of 40,000 medical sciences universities that more than annual cases of scorpion sting in Tunisia, about 75% of them are children. Among them, 1000 individuals are admitted in hospitals between 7 to 60 cases of scorpionism events because of clinical manifestations of which 100 lead to mortality (20). In addition to Khuzestan individuals are died (6,7,8). Until now, province with highest rate of scorpionism, some approximately 1500 scorpion species have been other cases have been reported from other identified spreading throughout the world with provinces including Hormozgan, Sistan and more prevalence of occurrences in tropical and Baluchestan, Fars, Ilam, Bushehr, Kerman, subtropical regions. About 50 species of Kohkiluyeh and buyerahmad, Kermanshah, scorpions need special health and medical Isfahan, Khorasan, Western Azarbayjan, importance (4). The situation of scorpionism Kurdestan, Tehran, Qom, Eastern Azarbayjan, varies in different regions and countries in Ardebil, Markazi, Gilan, Lorestan, Semnan, terms of life style, socio-economical status, Mazandaran and Golestan (11). Central and Downloaded from jhygiene.muq.ac.ir at 23:08 IRST on Friday December 14th 2018 residency, the way of offering health care southern regions of Iran have special services and scorpion species of each importance compared with other regions in geographical area (9). Iran is rich of arthropods terms of scorpion and snake sting because of especially scorpions because of weather and socio-economical, geographical and cultural climate factors (10). 44 scorpion species of 23 status. People in tropical rural areas, for genus have been identified and characterized in instance, sleep outdoor in summers making Iran; all of them belonging to two Buthidae and possible the occurrence of scorpionism. Scorpionidae families with 6 species of health Because of relatively high prevalence of importance including Mesobuthus eupeus, scorpionism in rural and urban areas of Qom Hemiscorpius lepturus, Buthotus (Hottentotta) province and absence of a comprehensive study saulcyi, Odonthobuthus doriae, Androctonus in this regard, applicable solutions in order to crassicauda and Buthotus (Hottentotta) schach. prevent this major health issue could be These species are the most prevalent scorpions provided for health service programmers via causing scorpionism in Iran in which Buthotus knowing about epidemiological status, (Hottentotta) schach is determined as the most ----------------------------------------------------------------- ------------------------------------------------------------ Archives of Hygiene Sciences Volume 6, Number 2, Spring 2017 © 2017 Publisher: Research Center for Environmental Pollutants, Qom University of Medical Sciences. All rights reserved. 146 •Epidemiologic Status of Scorpion Sting ... Saghafipour A, et al. / Arch Hyg Sci 2017;6(2): 145-151 prevalence, high-risk age groups and other analyzed by computer. Relative frequency table indicators which are related to scorpionism. and consensus table were used to describe classified variables. Chi-square test and Fischer Aims of the study: exact test were used for analytical part of study. Obtained p-values which were less than 0.05 Materials & Methods considered as a significance level. All This study is a descriptive cross-sectional one mentioned statistical analyses were performed with case studies which were obtained from by SPSS v.17. scorpion-stung people profiles in urban and Results rural areas of Qom province