ABSTRACT:The present study aimed at verifying the impact of a Moroccan strategy against scorpion stings and specifically at identifying the epidemiological features of patients envenomed or just stung by scorpions. It included 11,907 patients from El Kelaa des Sraghna Province, Morocco, who were evaluated over five years (2001)(2002)(2003)(2004)(2005). Most stings occurred during the hot period and mainly at night. The average incidence was 3.2 per 1,000 inhabitants; patients ≤15 years accounted for 34%, and the envenomation rate was 12%. Average lethality rate was 0.7%. Our work evaluated the efficacy of the adopted strategy based on indicators of follow-up, morbidity and lethality due to scorpion sting and envenomation.

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The objective of this work is to analyse and interpret data from patients bitten by scorpions in a province of Morocco in order to reduce morbidity and mortality caused by scorpion venom. A study was conducted of 901 cases of poisoning among 6959 cases of scorpion stings recorded between January 2002 and December 2006 from bites recorded in Beni Mellal. The results show that poisoning strongly coincides with the summer period, especially in July and August. All age groups are affected by this disease with an average age of 17.28 +/- 17.91 years. For the time post injection, 35.2% were able to check in under an hour. On the other hand, 70.9% reach a health facility with symptoms (class II) and 29.1% with signs of distress (Class III). Finally, the evolution of patients is mostly positive in 94.7% of cases, and the case fatality rate from scorpion sting poisoning is 3.88%.

Scorpion stings comprise a serious problem throughout the globe, especially in regions where they are more frequent. In Morocco, Beni Mellal is one of the provinces most affected by this burden. This study aimed to trace the epidemiological profile of scorpion stings in Beni Mellal in order to improve patient care and prevent both morbidity and mortality. Our work is a retrospective study of scorpion stings based on medical charts of Beni Mellal. From 2002 cases were registered in this province with an average incidence of 1.36‰. The stings were more frequent in summer months, particularly July and August, and between 6 p.m. and 6 a.m. (59.8%). The average age of victims was 26.54 ± 18.42 years. Children were affected in 30.3% of the cases. Of all registered cases, 67.3% of the patients received medical aid in less than an hour after the sting. The envenomation rate (Class II and Class III) was 12.4% and the overall case-fatality rate was 0.42% with a mortality rate of 0.005‰. Statistical analysis of the various studied factors revealed a significant connection among the envenomation class, patient age and evolution.

Résumé -L'analyse descriptive a porté sur les paramètres socio-démographiques (âge, sexe, temps post-piqûre (TPP)), cliniques et thérapeutiques. Nous avons effectué l'analyse univariée pour identifier les facteurs associés aux décès par envenimations scorpioniques (selon le test de chi 2 ou de Fischer, l'association est statistiquement significative si p < 0,05). Résultats : 240 patients ont été inclus dans notre étude, l'âge médian était de 12 ans, allant de 1 à 86 ans, le sex ratio était de 1,25. Le TPP médian était de 2 h allant de 10 min à 29 h. 9,6 % des patients ont présenté une détresse respiratoire, l'atteinte cardiovasculaire était présente dans 10,8 % des cas suivie par la détresse neurologique dans 10,4 % des cas. 11,3 % des cas étaient de classe III à l'admission. L'évolution était favorable dans 91,7 % des cas. 20 décès ont été enregistrés soit 8,3 % des cas. La fièvre, l'hypersudation, les vomissements et la tachypnée étaient statistiquement associés au décès (p < 0,05). Conclusion : Le décès par envenimation scorpionique à la province d'El Kelâa des Sraghnas reste fréquent malgré les efforts fournis, d'où l'intérêt de l'implantation de l'audit clinique des décès afin de déceler les insuffisances pour y remédier. Mots clés : Envenimation scorpionique, facteur prédictif, décès, Maroc Abstract -Objective: To identify the clinical signs associated with death by envenomation scorpions, based on hospital files of the hospital Essalama in El Kelâa des Sraghnas received during 2007. Patients and Methods:Prospective study of scorpions envenimation cases, from the hospital files designed and distributed by Moroccan Poison control centre. The study is conducted in adult and pediatric resuscitation. The descriptive analysis focused on the sociodemographic parameters (age, sex, time post sting (TPP)), clinical and therapeutical features. We conducted univariate analysis to identify predicting death factors by scorpion envenomation (chi 2 test or Fischer, the association is statistically significant if p < 0.05). Results: 240 patients were included in our study, the median age was 12 years ranging from 1 to 86 years. The sex ratio was 1.25. The median TPP was 2 h (from 10 min to 29 h). 9.6% of patients had respiratory distress; cardiovascular achievement was present in 10.8% cases followed by neurological distress in 10.4% of cases. 11.3% of cases were class III at admission. The outcome was favourable in 91.7% of cases. 20 deaths were recorded (8.3%). The fever, sweating, vomiting and tachypnea are statistically associated with death (p < 0.05). Conclusion:Death from scorpion envenomation in the province of El Kelâa des Sraghnas remains high despite the efforts, therefore, the clinical audit of deaths is needed to detect shortcomings to remedy.

Résumé - Mots clés : Envenimation, scorpion, épidémiologie, fiches d'hospitalisation, Beni MellalAbstract -In Morocco, the province of Beni Mellal is one of the regions most affected by the problem of scorpion sting and envenomation. Objective: The aim of this research is to reduce cases of morbidity and mortality subsequent to scorpion envenomation through the analysis and interpretation of data recorded in hospital admission forms. Patients and methods: Our study covered 56 retrospective cases of scorpion poisoning during the year 2007, which were reported by the hospital's intensive care service in Beni Mellal province. Results: Results indicate that scorpion envenomation occurs mainly during summer time, in particular during June and July. Moreover, stings happen at night between 6PM and 6AM (56.8%). Youngsters with age less than or equal to 15 years are those most exposed to envenomation, with a male age of 14.92 ± 12.94 years. Furthermore, 71.4% of the hurt patients arrive at the hospital with general symptoms and 28.6% exhibit signs of vital distress. The therapy is still variable, and the rate of lethality at hospital is 8.92%. Statistical analysis of various factors studied in relation to survival prediction (recovery and mortality) showed a highly significant difference for each admission class (χ 2 = 13.72 and p < 0.001). Age of less than 15 years and cardiovascular are factors of risk for envenomed patients. Conclusion: Scorpion envenomation remains a public health problem in Morocco.

Résumé - Mots clés : Envenimation, scorpion, épidémiologie, fiches d'hospitalisation, Beni MellalAbstract -In Morocco, the province of Beni Mellal is one of the regions most affected by the problem of scorpion sting and envenomation. Objective: The aim of this research is to reduce cases of morbidity and mortality subsequent to scorpion envenomation through the analysis and interpretation of data recorded in hospital admission forms. Patients and methods: Our study covered 56 retrospective cases of scorpion poisoning during the year 2007, which were reported by the hospital's intensive care service in Beni Mellal province. Results: Results indicate that scorpion envenomation occurs mainly during summer time, in particular during June and July. Moreover, stings happen at night between 6PM and 6AM (56.8%). Youngsters with age less than or equal to 15 years are those most exposed to envenomation, with a male age of 14.92 ± 12.94 years. Furthermore, 71.4% of the hurt patients arrive at the hospital with general symptoms and 28.6% exhibit signs of vital distress. The therapy is still variable, and the rate of lethality at hospital is 8.92%. Statistical analysis of various factors studied in relation to survival prediction (recovery and mortality) showed a highly significant difference for each admission class (χ 2 = 13.72 and p < 0.001). Age of less than 15 years and cardiovascular are factors of risk for envenomed patients. Conclusion: Scorpion envenomation remains a public health problem in Morocco.