Estudo epidemiológico dos acidentes por serpentes associados aos usos da terra em Manhuaçu - MG, de 2007 a 2015

• Ano de defesa: 2018
• Autor(a) principal: Laís Perígolo Mól
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: serpentes; lavouras; botrópico; peçonhentos; soroterapia; Ciência animal
• Link de acesso: http://hdl.handle.net/1843/SMOC-AYJQNH

Snake accidents still are a serious neglected public health problem. The antiophidic serum is used for treatment and it is widely available in the country. However, the lack of knowledge about the identification of venomous snakes and the symptoms of an accident increase therapy failures. The mortality or sequel of a victim may result from poison toxicity, inoculated amount and treatment efficacy. Its necessary to search the health service imediately after an snake accident, since the time lapse between the accident and the beginning of the treatment has a direct association with the severity of the cases. The city of Manhuaçu, in Minas Gerais, is a reference center of the Unified Health System (SUS) for the treatment of the victims of the region and has the highest number of notifications of the state. The present study seeks to describe the dynamics of the occurrence of snake accidents in Manhuaçu, characterize the profile of the pacients, evaluate the treatment with antiophidic serum and associate the accidents to the use of land in Manhuaçu. A descriptive and retrospective analysis of the data of the Information System of Notification Diseases (SINAN) was carried out using Excel 10.0 and Stata 12.0. Secondary data from the Brazilian Institute of Geography and Statistics (IBGE) were used for socio-environmental characteristics of the city. In total, 360 snake accidents were studied in 2007-2015. It was observed that 278 (77.2%) were men, 204 (56.6%) adults, 232 (64.4%) were bitten in the lower limbs. Regarding the occurrence of the accident, 289 (80.2%) occurred in the rural area. Furthermore, 169 (46.9%) cases were work related and 194 (53.8%) victims had an occupation related to agriculture, which could be an even larger number considering the respective 76 (21.1%) and 152 (42.2%) cases that ignored the profession of the victim. It was verified that 313 (86.9%) are bothropics accidents (genus Bothrops) and 40 (11.1%) cases were ignored, not identifying the snake. Regarding the treatment, 274 (76.1%) patients were treated less than 3 hours after the poisoning and 324 (90%) received antiofidic serum. The agreement of the number of ampoules used in relation to the severity of the patients' clinical condition, calculated by the Kappa coefficient (p<0,05), was 59.81%, classified as moderate. In the period of time analyzed, there was no death due to snake bite. The month with more accidents with snakes was May (IC 95%=3,3±0,309), differing from the pattern observe in Southeast region. The inertia percentage of the main components analysis system was 82 and 87%, showing, respectively, the incidence and gravity of the accidents associated with environmental variables that would increase food availability for snakes. The lack of data in filling in the notification form makes it impossible to fully characterize the occurrence of accidents. The evaluation of the treatment was effective, despite the occurrence of cases that were not in accordance of Ministry of Health recommendation. The analysis of the characterics of the accidents in Manhuaçu allow to infer specific environmental conditions that deserver further studies. The results aim to orientate interventions and contribute to a better organization of health services in the prevention, diagnosis and treatment of cases in the municipal sphere.