02418nas a2200289   4500000000100000008004100001653003900042653001500081653001100096653001100107100001500118700001400133700001400147700001400161700001600175700001500191700001200206700002100218700001600239700001500255245013800270856007300408300001000481490001500491520160800506022001402114       2015                            d10aNeglected tropical diseases (NTDs)10aSnakebites10aAmazon10aBrazil1 aFeitosa ES1 aSampaio V1 aSachett J1 aCastro DB1 aNoronha MDN1 aLozano JLL1 aMuniz E1 aLima Ferreira LC1 aLacerda MVG1 aMonteiro W00aSnakebites as a largely neglected problem in the Brazilian Amazon: highlights of the epidemiological trends in the State of Amazonas.  uhttp://www.scielo.br/pdf/rsbmt/v48s1/0037-8682-rsbmt-48-s1-00034.pdf  a34-410 v48 Suppl 13 a<p>Envenoming snakebites are thought to be a particularly important threat to public health worldwide, especially in rural areas of tropical and subtropical countries. The true magnitude of the public health threat posed by snakebites is unknown, making it difficult for public health officials to optimize prevention and treatment. The objective of this work was to conduct a systematic review of the literature to gather data on snakebite epidemiology in the Amazon region and describe a case series of snakebites from epidemiological surveillance in the State of Amazonas (1974-2012). Only 11 articles regarding snakebites were found. In the State of Amazonas, information regarding incidents involving snakes is scarce. Historical trends show an increasing number of cases after the second half of the 1980s. Snakebites predominated among adults (20-39 years old; 38%), in the male gender (78.9%) and in those living in rural areas (85.6%). The predominant snake envenomation type was bothropic. The incidence reported by the epidemiological surveillance in the State of Amazonas, reaching up to 200 cases/100,000 inhabitants in some areas, is among the highest annual snakebite incidence rates of any region in the world. The majority of the cases were reported in the rainy season with a case-fatality rate of 0.6%. Snakebite envenomation is a great disease burden in the State of Amazonas, representing a challenge for future investigations, including approaches to estimating incidence under-notification and case-fatality rates as well as the factors related to severity and disabilities.</p>
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