Clinico-epidemiology of arthropod stings and bites in primary hospitals of North Western province of Sri Lanka

Autor:	Shantha S. Rathnayake, Senanayake A. M. Kularatne, Andrew H. Dawson, Seyed Shahmy
Rok vydání:	2018
Předmět:	Adult Male 0301 basic medicine Emergency Medical Services medicine.medical_specialty Population Snake Bites Toxicology Hospital records Young Adult 03 medical and health sciences 0302 clinical medicine Spider Bites parasitic diseases Epidemiology Animals Humans Medicine 030212 general & internal medicine education Envenomation Arthropods Retrospective Studies Sri Lanka education.field_of_study Scorpion Stings business.industry Incidence Incidence (epidemiology) Insect Bites and Stings General Medicine Middle Aged medicine.disease Hospitals eye diseases 030104 developmental biology Median time Female Sri lanka business Anaphylaxis Demography
Zdroj:	Clinical Toxicology. 56:880-885
ISSN:	1556-9519 1556-3650
DOI:	10.1080/15563650.2018.1447120
Popis:	Arthropod stinging and bites are common environmental hazards in Sri Lanka. However, their medical importance has not been fully evaluated yet. This study aims to study the burden, epidemiology, and outcome of stings and bites in primary hospitals in the Kurunegala district in North Western Province (NWP) of Sri Lanka.The study was conducted one year from 25th May 2013 to 25th May 2014. Details of all stings and bites admissions and their outcomes were retrospectively extracted from hospital records in all 44 primary hospitals in the district.There were 623 stings and bites with population incidence of 38/100,000 (95% CI 27-52). There were no deaths. Median age was 38 years (IQR: 19-53 years), and 351 (56%) were males. Most of stings and bites (75%) occurred in the daytime. Median time to hospital arrival was 55 minutes (IQR: 30 min to 2 h). The offending arthropods had been identified in 557 (89%) cases, of them, 357 (57%) were Hymenoptera (hornet and bees), 99 centipedes, 61 spiders and 40 scorpions. Local pain occurred in 346 (56%) cases - centipede 69 (70%), Scorpion 24 (60%), spider 36 (59%), Hymenoptera 187 (52%) and unidentified 30 (45%). Hymenoptera stings and spider bites occurred between 06 am to 12 noon, and scorpion stings and centipede bites mostly occurred between 06 pm to 12 midnight. Mild, moderate to severe anaphylaxis reactions occurred in 173 (28%) patients including 110 Hymenoptera stings - mild 39, moderate 62 and severe 9. From primary hospitals, 53(9%) cases had been transferred to tertiary care units for further management. Of them, 41 cases were Hymenoptera stings and 24 (58%) of them had mild, moderate to severe anaphylaxis. In the entire group, 27% severe cases received adrenaline.The primary hospitals in NW province of Sri Lanka manage large numbers of arthropod stings and bites. These include Hymenoptera (hornet and bee), centipedes, spiders, and scorpions. Pain, swellings and anaphylactic reactions were the most common adverse effects.
Databáze:	OpenAIRE
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