Analysis of the coverage of the network of strategic points of reference for the diagnosis and treatment of scorpionism and the demand for scorpion serum in the state of São Paulo

• Grant number: 23/07172-3
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: September 01, 2023
• End date: August 31, 2024
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal Investigator: Francisco Chiaravalloti Neto
• Grantee: Gabriella Pereira dos Santos
• Host Institution: Faculdade de Saúde Pública (FSP). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Scorpionism is a serious public health problem that particularly affects areas with a tropical and subtropical climate, which are more conducive to the life and reproduction of scorpions. In Brazil, poisoning with scorpion toxin, particularly the Tityus serrulatus species, the most venomous in the country, leads to a large number of cases, having exceeded 120,000 cases per year since 2017. The state of São Paulo, which concentrates a large part of the notifications, contains physical and social characteristics that, together with the increasing presence of T. Serrulatus, explain its epidemiological situation. Despite not having a very high general mortality rate, when looking at the age group of children between 0 and 9 years old, where most deaths originate, the situation becomes more critical, especially when one takes into account that the main risk factor, both for deaths and for the development of more severe symptoms, is the time between the bite and the start of treatment with serum. This, together with the large number of cases, which continues to grow annually, makes it essential to have a capable service network with adequate coverage to meet the demand for serum therapy. Therefore, the proposed work will be devoted to evaluating the adequacy of the coverage of the network of Strategic Points for diagnosis and antiscorpion serum therapy (SP's), which perform care for accidents with scorpions, which is characterized by a problem that seeks to maximize the coverage of population. The study will take into account the road network and its traffic volume in order to determine whether all locations in the state are within a maximum safe travel time, 90 minutes, of a SP. The problem will be approached through emergency system location models and will be solved using exact or heuristic approximations, depending on the complexity of the Strategic Points network. The appropriate amount of ml of serum will also be determined, taking into account the peak occurrence of scorpion stings between the years 2010 to 2020 and the proportion of mild, moderate and severe cases. At the end of this project, it is expected that the results will be made available in the form of an article and disseminated in congresses. Its main meetings will be presented to state and federal health services, in order to serve as a basis for establishing more effective public policies