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Zotero
EndNote
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Scorpion Envenoming as an Emerging Public Health Problem in Paraguay, Bolivia, and Midwest Brazil: Involvement of Tityus confluens and the Need for a Panregional Evaluation of Available Antivenoms
Adolfo Borges
borges.adolfo@gmail.com
Adolfo Borges
Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay;
Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela;
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Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela;
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Antonieta Rojas de Arias
Antonieta Rojas de Arias
Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay;
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Ana María Montaño
Ana María Montaño
Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra, Bolivia;
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Cláudio Mauricio V. de Souza
Cláudio Mauricio V. de Souza
Laboratório de Artrópodes, Instituto Vital Brazil, Niterói, Brazil
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ABSTRACT.
This contribution highlights the emergence of a newly endemic region for scorpion envenoming in South America, covering eastern Bolivia, Paraguay, and the midwestern Brazilian states of Mato Grosso and Mato Grosso do Sul. These areas have not historically been known to harbor life-threatening scorpion species. Tityus confluens, a parthenogenetic species of medical significance in Argentina, has been identified in severe and lethal human cases in Bolivia and Paraguay. Given that the clinical use of scorpion antivenom preparations in the region has often lacked preclinical data and considering the significant burden of scorpion envenoming, we propose a panregional evaluation of available anti-Tityus antivenoms. This evaluation, along with interdisciplinary efforts at a multinational scale to control scorpionism, aims to determine their true neutralization capacity and potential clinical efficacy against known culprits in the Southern Cone of South America and other regions endemic for scorpion envenoming on the continent.
Author Notes
Current contact information: Adolfo Borges, Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay, and Instituto de Medicina Experimental, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela, E-mail: borges.adolfo@gmail.com. Antonieta Rojas de Arias, Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay, E-mail: rojasdearias@gmail.com. Ana María Montaño, Centro Nacional de Enfermedades Tropicales, Santa Cruz de la Sierra, Bolivia, E-mail: anamontano.biologa@gmail.com. Cláudio Mauricio V. de Souza, Laboratório de Artrópodes, Instituto Vital Brazil, Niterói, Brazil, E-mail: artropodos@vitalbrazil.rj.gov.br.
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Reference Manager
BibTeX
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EndNote
-
1.
Chippaux JP, 2012. Emerging options for the management of scorpion stings. Drug Des Devel Ther 6: 165–173.
-
2.
Laraba-Djebari F, Adi-Bessalem S, Hammoudi-Triki D, 2015. Scorpion venoms: Pathogenesis and biotherapies. Gopalakrishnakone P, Schwartz EF, Possani LD & Rodríguez de la Vega RC Scorpion Venoms. Dordrecht, The Netherlands: Springer Dordrecht, 63–106.
-
3.
Khemili D, Laraba-Djebari F, Hammoudi-Triki D, 2019. Involvement of Toll-like receptor 4 in neutrophil-mediated inflammation, oxidative stress and tissue damage induced by scorpion venom. Inflammation 43: 155–167.
-
4.
Reis MB, Zoccal KF, Gardinassi LG, Faccioli LH, 2019. Scorpion envenomation and inflammation: Beyond neurotoxic effects. Toxicon 167: 174–179.
-
5.
Delgado-Prudencio G, Cid-Uribe JI, Morales JA, Possani LD, Ortiz E, Romero-Gutiérrez T, 2022. The enzymatic core of scorpion venoms. Toxins (Basel) 14: 248.
-
6.
Amaral CFS, Rezende NA, 2000. Treatment of scorpion envenoming should include both a potent specific antivenom and support of vital functions. Toxicon 38: 1005–1007.
-
7.
Boyer L, Degan J, Ruha AM, Mallie J, Mangin E, Alagón A, 2013. Safety of intravenous equine F(ab’)2: Insights following clinical trials involving 1534 recipients of scorpion antivenom. Toxicon 76: 386–393.
-
8.
Rebahi H, Ba-M’hamed S, Still ME, Mouaffak Y, Younous S, Bennis M, 2022. Clinical features and prognosis of severe scorpion envenomation in children. Pediatr Int (Roma) 64: e14687.
-
9.
Dupre G, 2023. Nouvelle répartition mondiale des scorpions. Arachnides 111: 1–12.
-
10.
Borges A, Graham MJ, 2016. Phylogenetics of scorpions of medical importance. Gompalanokrishnanone P & Calvete JJ Venom Genomics and Proteomics. Dordrecht, The Netherlands: Springer Netherlands, 81–103.
-
11.
de Roodt AR, 2014. Comments on environmental and sanitary aspects of the scorpionism by Tityus trivittatus in Buenos Aires City, Argentina. Toxins (Basel) 6: 1434–1452.
-
12.
de Souza CMV, Bochner R, 2022. Os Animais Peconhentos na Saúde Pública. Rio de Janeiro, Brazil: Editora Fiocruz.
-
13.
Borges A, et al., 2020. Venom diversity in the neotropical scorpion genus Tityus: Implications for antivenom design emerging from molecular and immunochemical analyses across endemic areas of Scorpionism. Acta Trop 204: 105346.
-
14.
Guerrero-Vargas JA, Rodríguez J, Ayerbe S, Flórez E, Beltrán J, 2015. Scorpionism and dangerous species of Colombia. Gopalakrishnakone P, Possani LD, Schwartz EF & Rodríguez de la Vega RC Scorpion Venoms. Dordretch, The Netherlands: Springer Netherlands, 245–272.
-
15.
Borges A, Graham MR, Cândido DM, Pardal PPO, 2021. Amazonian scorpions and scorpionism: Integrating toxinological, clinical, and phylogenetic data to combat a human health crisis in the world’s most diverse rainforest. J Venom Anim Toxins Incl Trop Dis 27: e20210028.
-
16.
Borges A, Román J, 2023. Case report: Fatal scorpion envenomation in a Shuar child by Tityus cisandinus from Amazonian Ecuador: A call for specific antivenom availability in the Amazon Basin. Am J Trop Med Hyg 108: 807–810.
-
17.
Monteiro WM, et al., 2019. Perspectives and recommendations towards evidence-based health care for scorpion sting envenoming in the Brazilian Amazon: A comprehensive review. Toxicon 169: 68–80.
-
18.
Guerra-Duarte C, Saavedra-Langer R, Matavel A, Oliveira-Mendes BBR, Chavez-Olortegui C, Paiva ALB, 2023. Scorpion envenomation in Brazil: Current scenario and perspectives for containing an increasing health problem. PLoS Negl Trop Dis 17: e0011069.
-
19.
de Roodt A, Lago N, Salomón O, Laskowicz R, Neder de Román L, López R, Montero T, Vega V, 2009. A new venomous scorpion responsible for severe envenomation in Argentina: Tityus confluens. Toxicon 53: 1–8.
-
20.
Ojanguren-Affilastro A, Bizzotto C, Lanari L, Lenicov MR, de Roodt A, 2019. Presencia de Tityus confluens Borelli en la ciudad de Buenos Aires y expansión de la distribución de las especies de importancia médica de Tityus (Scorpiones; Buthidae) en la Argentina. Rev Mus Argent Cienc Nat 21: 101–112.
-
21.
Borges A, Rojas de Arias A, 2019. El accidente por escorpiones tóxicos en el Paraguay: Mito y realidad en el contexto de la emergencia por escorpionismo en el sudeste de la América del Sur. Rev Soc Cient Parag 24: 27–35.
-
22.
Ardiles-Ruesjas S, Sanabria E, Portillo VHS, Jara L, Egea Vd, Sequera G, Alonso-Padilla J, Losada I, Pinazo MJ, 2024. Epidemiological and sociodemographic description of snakebite envenoming cases in Paraguay reported between 2015 and 2021. BMJ Public Health 2: e000359.
-
23.
Guerrero D, 2023. Arácnidos de Importancia Médica en Paraguay. XIV Muestra Nacional de Epidemiología. November 22–23, 2023. Asunción, Paraguay: Dirección General de Vigilancia de la Salud, Ministerio de Salud Pública y Bienestar Social de Paraguay.
-
24.
Ojeda MA, Neder de Román LE, 2017. Escorpiones y escorpionismo en la provincia de Jujuy. Acta Toxicol Argent 25: 12–22.
-
25.
Brites-Neto J, Duarte KM, 2015. Modeling of spatial distribution for scorpions of medical importance in the São Paulo State, Brazil. Vet World 8: 823–830.
-
26.
Von Eickstedt V, Ribeiro L, Candido DM, Albuquerque M, Jorge M, 1996. Evolution of scorpionism by Tityus bahiensis (Perty) and Tityus serrulatus Lutz and Mello and geographical distribution of the two species in the state of São Paulo-Brazil. J Venom Anim Toxins 2: 92–105.
-
27.
Lourenço W, 1979. La repartition géographique du complexe Tityus trivittatus (Scorpiones, Buthidae). Revista Nordestina de Biologia 2: 37–49.
-
28.
Auza-Santiváñez JC, Franco-Lacato AO, 2023. Picadura de escorpión en Bolivia: Una revisión crítica de la literatura. Gac Méd Boliv 46: 91–96.
-
29.
Acosta LE, Ochoa JA, 2002. Lista de los escorpiones bolivianos (Chelicerata; Scorpiones), con notas sobre su distribución. Rev Soc Entomol Argent 61: 15–23.
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