SCORPION STING, IS IT A HEALTH PROBLEM IN SAUDI-ARABIA - EVALUATION OF MANAGEMENT OF 820 CASES

The socio cultural disposition and geographical features of Saudi Arab ia exposes its inhabitants to the risk of contact with a variety of ve nomous animals. Although modern means of transportation have contribut ed to the decrease of such contact, the socio cultural habits prevalen t are still conducive to such risk. Only a few studies describe the in cidence rates of some venomous bites in the Kingdom of Saudi Arabia (K SA), but the size of the problem is not fully appreciated. Objectives: This work was conducted to study the incidence of scorpion stings at Hail region and to evaluate the prognosis in relation to the dose of a ntivenom received. Subjects and methods: This study involved all cases of scorpion stings that were admitted to all primary health care cent ers and hospitals at Hail region, Saudi Arabia, during the period betw een Ist June to end of November, 1994. A special scorpion sting sheet was prepared and completed by physicians at primary health care center s and hospitals for every case of scorpion sting. This sheet was sent to the Directorate of Health Affairs at Hail. Analysis of 820 case she ets received during this period was carried out. Incidence of scorpion stings was studied. Moreover treatment of these cases by antivenom wa s evaluated, Results and discussion: A total incidence of scorpion sti ngs of 0.68% per six months was found. Highest incidence of 0.84% per six months was found among those aged more than 15 years. Saudis and n on-Saudis had similar incidence and no sex difference was found. The i ncidence of scorpion stings detected is clearly higher than that repor ted from Libya and Algeria. The higher incidence of scorpion stings am ong those over 15 years of age, direct the attention to outdoor biting . This is mainly due to their occupation as shepherds and their habit of enjoying the desert during leisure time. This is also seen from the increased frequency of stings during late summer rather than early wi nter. Three hundred and thirty cases had received five ampoules of one ml antivenin (Nile Company, Egypt). The prognosis for both groups was the same without any mortality. Risk factors were considered, These i ncluded demographic factors and factors related to the sting and treat ment. The groups were found similar as regards these risk factors. Mor eover, only 211 (25.6%) of cases attended the hospital, the remaining cases refused referral after being treated at PHCs. This suggests that treatment at PHCs was successful by antivenin. The possible spontaneo us recovery due to affection by less toxic scorpion species is present (Type II statistical error), However, we can conclude that management by 5 ml antivenin is not superior to that using 1 ml antivenin. But d efinite conclusion regarding the value of the antivenin is to be studi ed by comparing symptomatic management versus treatment with antivenin in a controlled clinical trial.Conclusions: In conclusion treatment w ith five ampoules was not shown to be superior to the previous regimen with one ampoule, 1 ml antivenin. In addition, the high incidence of scorpion stings at Hail region directs attention to the urgent need fo r starting preventive community programs to decrease the incidence of scorpion stings.