Situation épidémiologique des envenimations scorpioniques dans la province de Beni Mellal

Résumé - Mots clés : Envenimation scorpionique, facteurs pronostiques, décès, MarocAbstract -Objective: The objective of our study was to identify the prognostic factors of death by scorpion envenomation in the region of Marrakech. Methods: We conducted a case-control study. It involved children hospitalized in the pediatric intensive care unit of the University Hospital of Marrakech after a scorpion envenomation between 1 October 2009 and 31 October 2012. An operating sheet was filled with the records of hospitalizations designed by the Poison Control Center of Morocco. Cases (n = 30) are represented by the children living in the area and who died during their hospitalization. For each case, we selected four witnesses among the survivors. A descriptive analysis, bi-and multivariate, was performed. Results: The median age was 5 years [2 months-14 years]. The M/F sex ratio was 1.5. The median delay between the bite and admission to the intensive care unit (TPP2) was 3 h 40 min [30 min-25 h]. Clinical signs commonly reported were vomiting (83%), priapism (72%) and sweating (70%). Biologically, leukocytosis, the hemostasis disorders, hyperglycemia and hyperuremia were statistically related to the death. Multivariate analysis showed that TPP2 > 5 h increased the risk of progressing to death five times, adjusting for age and vital distress (CI 95% 1.6-17). Conclusion: The upgrade of technical equipment and specialized personnel in the provincial resuscitation units are key elements to reduce TPP2, which is an important prognostic factor of death by scorpion envenomation in the Marrakech-Tensift-Al Haouz region.

Section: Discussionunclassified

Facteurs pronostiques du décès par envenimation scorpionique dans la région de Marrakech, Maroc

Rachid¹,

Khattabi²,

Amine³

et al. 2013

“…20 décès ont été enregistrés avec une létalité de 8,3 %, supérieure au taux national (0,86 %) et à d'autres zones endémiques marocaines (Khouribga, Beni-mellal) [33,34]. Ce taux s'inscrit parmi les zones à forte létalité.…”

Section: Discussionunclassified

Les facteurs prédictifs du décès par envenimation scorpionique à la province d'El Kelâa des Sraghnas – Maroc

Achour¹,

Khattabi²,

Oufir³

et al. 2009

Self Cite

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.

“…Nos données sont concordantes avec celles rapportées dans la littérature [8][9][10], ce qui confirme la relation entre la dose de venin injectée et le poids corporel du patient piqué [11].…”

Section: Discussionunclassified

Les caractéristiques épidémiologiques et cliniques des envenimations scorpioniques dans la province de Beni Mellal (Maroc)

Charrab¹,

Soulaymani²,

Semlali³

et al. 2009

Self Cite

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.