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Epidemiological, toxicological and physiopathological characteristics of scorpion stings and their management in Morocco: A literature review

Journal

ACTA TROPICA
Volume 239, Issue -, Pages -

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ELSEVIER
DOI: 10.1016/j.actatropica.2022.106812

Keywords

Scorpions; Stings; Epidemiology; Toxicology; Physiopathology; Morocco

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Scorpion envenomation is a global public health issue, with Morocco being particularly affected. This review highlights the characteristics of scorpion stings and envenomation in Morocco, including epidemiology, toxicology, and management. Risk factors for a poor prognosis include age, admission class, season, serum venom concentration, and delay in medical intervention.
All around the world, scorpion envenomation represents a public health issue. In Morocco, it represents the first cause of poisoning. The aim of this review is to highlight the epidemiological, toxicological and physiopathological characteristics of scorpion stings and envenomation in Morocco as well as their management. According to the bibliography, the most areas affected by scorpion stings and envenomation are those in the center and south of Morocco. Lethality rate is more important in children than adult. Age, admission class, season, serum venom concentration, and the time elapsed between the scorpion sting and medical intervention are risk factors for a poor prognosis. Until now, we have only known the LD50 of 14 scorpion species from three genera: Androctonus, Buthus and Hottentota, and only 6 species, out of 61 moroccan scorpions, have been assessed for their venom toxicity on mice organs. The venom of harmful moroccan scorpions induces several histopathological changes in the myocardium, brain, liver, pulmonary alveoli, and kidneys in rats, as well as severe consequences in the lungs with intra-alveolar hemorrhage. There was also a significant increase in serum enzyme levels of aspartate transaminase (AST), alanine transaminase (ALT), creatine phosphokinase (CPK), and lactate dehydrogenase (LDH), as well as high levels of plasma albumin, creatine and glucose. In the absence of a specific treatment, the management of scorpion envenomation is based only on symptomatic therapy. We noted a widely use of traditional remedies. Despite the magnitude of the scorpion problem in Morocco, it remains understudied and continues to claim lives, particularly given the lack of an efficient etiological cure.

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