Epidemiologia dos acidentes com serpentes em São Gabriel da Cachoeira - Amazonas

Abstract

Snakes (Ophidia) are part of the Squamata, which together with Testudines, Crocodylia and Sphenodonta, are traditionally called: Reptiles. Brazil holds a prominent global position in terms of snakes diversity, with 430 identified species. However, only a small percentage of these are venomous. Snakebite incidents are subject to mandatory reporting in the country and occur most frequently in the Northern region, particularly within the Amazon Basin. São Gabriel da Cachoeira, located in the state of Amazonas, is among the most affected municipalitie. The distance from urban centers and the challenging access to remote areas hinder the timely and adequate treatment of victims. The objective of this study was to analyze the epidemiology of snakebite accidents in the municipality of São Gabriel da Cachoeira, located in the Northern region of Brazil, in the state of Amazonas. For this purpose, data from SINAN (Information System for Notifiable Diseases) from 2007 onward were used, specifically related to snakebite incidents. Within this scope, the category "Accidents by Venomous Animals" was selected, focusing on the period from 2014 to 2023. This is a descriptive study conducted through the DATASUS website, using the options: "Epidemiology and Morbidity" and subsequently "Notifiable Diseases and Conditions – (SINAN)”. The extracted data were organized and systematized in Microsoft Excel spreadsheets, which were also used for the quantitative analysis of the information. Epidemiological variables were analyzed, including the number of incidents and the types of snakes involved, the seasonal variation of cases, distribution by age group, sex, and ethnicity, the time elapsed until medical care, the location of the bite, administration of antivenom therapy, case outcomes, and the clinical severity of the snakebite incidents. The results indicated a higher occurrence of accidents involving snakes of the Bothrops genus (74%), especially affecting male individuals (402 cases), aged between 20 and 59 years. Most accidents occurred between May and July, predominantly in rural areas, among indigenous populations. The lower limbs were the most affected regions, especially the feet. Most cases were treated within the first three hours, with widespread use of antivenom therapy. However, despite the majority of cases resulting in recovery, significant challenges remain, particularly in the identification of snake species, the proper completion of notification forms, and access to medical care—especially in remote areas.