OBJECTIVES: The aims of this study were to highlight some epidemiological aspects of scorpion envenomations, to analyse and interpret the available data for Biskra province, Algeria, and to develop a forecasting model for scorpion sting cases in Biskra province, which records the highest number of scorpion stings in Algeria. METHODS: In addition to analysing the epidemiological profile of scorpion stings that occurred throughout the year 2013, we used the Box-Jenkins approach to fit a seasonal autoregressive integrated moving average (SARIMA) model to the monthly recorded scorpion sting cases in Biskra from 2000 to 2012. RESULTS: The epidemiological analysis revealed that scorpion stings were reported continuously throughout the year, with peaks in the summer months. The most affected age group was 15 to 49 years old, with a male predominance. The most prone human body areas were the upper and lower limbs. The majority of cases (95.9%) were classified as mild envenomations. The time series analysis showed that a (5,1,0)×(0,1,1)12 SARIMA model offered the best fit to the scorpion sting surveillance data. This model was used to predict scorpion sting cases for the year 2013, and the fitted data showed considerable agreement with the actual data. CONCLUSIONS: SARIMA models are useful for monitoring scorpion sting cases, and provide an estimate of the variability to be expected in future scorpion sting cases. This knowledge is helpful in predicting whether an unusual situation is developing or not, and could therefore assist decision-makers in strengthening the province’s prevention and control measures and in initiating rapid response measures.
Algeria* ; Epidemiology ; Forecasting* ; Human Body ; Humans ; Lower Extremity ; Male ; Scorpion Stings* ; Scorpions* ; Seasons*

INTRODUCTIONThe aim of this study was to evaluate the feasibility of non-invasive positive pressure ventilation through a new interface helmet in the treatment of cardiogenic pulmonary oedema due to scorpion sting envenomation in children.

CLINICAL PICTUREThree patients presented with fever, and respiratory distress following scorpion sting. Their cardiac enzymes were abnormal. Electrocardiogram (ECG) of 3 patients showed features of myocardial strain with ST elevation. Bedside chest X-ray taken in emergency showed marked bilateral infiltrates suggestive of pulmonary oedema. M-mode, two-dimensional colour-flow Doppler echocardiogram showed left ventricular dysfunction.

TREATMENT AND OUTCOMEAt paediatric intensive care unit admission, they were treated with antivenom, prazosin (0.03 mg/kg/dose), dopamine (15 mcg/kg/ min), dobutamine (10 mcg/kg/min) and nitroprussid (1 mcg/kg/min). Epinephrine (0.1 mcg/kg/ min) were added later. They were hypoxic and dyspnoeic. A slight sedation was induced with ketamine and/or midazolam. Non-invasive pressure support ventilation (NPSV) was delivered via the helmet by means of an intensive care unit ventilator. We evaluated the effect of NPSV delivered by helmet on oxygenation, respiratory rate, haemodynamics, complications and outcome. An improvement of oxygenation was observed within 2 hours of treatment.The helmet was well tolerated by all the children. No complications occurred in the 3 patients.

CONCLUSIONThis new approach of delivering NPSV through a helmet allows the successful treatment of cardiogenic pulmonary oedema in children with scorpion sting envenomation, assuring a good tolerance without complications. Future studies are needed before recommending the extensive application of this technique in all cases of cardiogenic pulmonary oedema due to scorpion sting envenomation.

Animals ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Positive-Pressure Respiration ; instrumentation ; methods ; Pulmonary Edema ; etiology ; therapy ; Respiratory Insufficiency ; etiology ; therapy ; Scorpion Stings ; complications ; therapy ; Scorpions ; Ventricular Dysfunction, Left ; etiology ; therapy