Venomous bites and stings

Introduction Venomous bites and stings are a serious medical, social and economic problem in many parts of the world, especially in tropical countries of Africa, South America, South East Asia and Middle East. They are an occupational disease of many professionals with consequences underestimated and never projected truly in health statistics. Objective of this study was to detect and evaluate the true burden, effects of envenoming, distribution and epidemiology of bites and stings in the Sultanate of Oman (SO). Methods This was an observational study recording the last 5 years cases of bites/stings (BS) of reptiles, arthropods (scorpions, spiders, insects, bees and wasps) and venomous marine animals. Data were collected from all the referral hospitals of the all 11 different regions of the SO, from the Armed Forces Hospitals and the Ministry of Health. Settings and classifications of the different species of venomous animals were described, such as clinical history and features, diagnosis, principles of management and outcome of the treatment protocols applied. Results The Sultanate of Oman is inhabited by a number of venomous animals which are of potential medical importance. The incidence rate for the last 5 years showed a total of 1527 cases of snakebites (19 species); 17872 cases of scorpion stings (24 species and subspecies), Leiurus, Androctonus, Buthus and Nebo are the most important genera from the medical point of view. Incidence of that BS in SO is double compared to that of the close Kingdom of Saudi Arabia, 0.02% vs 0.04% for snakebite and 0.2% vs 0.4% for scorpions. 9788 cases of bees/wasps stings and spider bites were reported, data doubled within 5 years. Furthermore 178 cases from marine animal and 1963 cases from unknown insect bite. Timing of therapeutic intervention appear to be critical to decrease morbidity, pain and mortality. Conclusions Venomous bites and stings are an important medical emergency and cause of hospital admission. Mortality and morbidity (mainly chronic) remain uncertain because of inadequate information. Antidotes are not always readily available, are often expensive and have a short-term expiration date, thus our mapping should help to plan and set up specifically equipped and easily accessible services.