Escorpionismo no Brasil com ênfase no Rio de Janeiro:: subsidiando políticas públicas para populações expostas /Claudio Maurício Vieira de Souza

Scorpions stings in Brazil increased 600% between 2001 and 2015 and in 2014 the number of deaths due these cases exceeded the fatalities caused by ofidism. Deaths related to scorpionism are mandatory reporting to SINAN, SIM and SIH-SUS however, between 2001 and 2015 there is a great discrepancy for Rio de Janeiro state data between these information systems, with 18 cases reported to SINAN, 10 to SIM and one to SIH-SUS. This initial finding supported the health sentinel event concept application to study these deaths, context analysis and also the social determinants involved to evaluate the suitability of \201Cneglected disease" conception to this problem. We used an interdisciplinary and qualitative quantitative methodological approach to examine the databases of the three information systems and, in an attempt to overcome the invisibility of the people involved, analyzed the statement contents of deceased victims\2019 relatives and from those professionals in charge of local actions addressing scorpionism, resulting in a polyphonic and inclusive discourse community. To approach the reality of exposed populations to the scorpionism we observed demographic, environmental, educational, economic and health indicators. We verified incomplete and typing errors, incompleteness and inconsistencies, duplicities and registered cases of deaths that did not occur Also confirmed 13 deaths due to scorpionic accidents, 11 reported to SINAN, 13 to SIM and five to SIH-SUS. This imbalance indicates the need for training and involvement of health professionals for their appropriation of uses and potential of the information systems analyzed. It was pointed out that is mandatory information systems databank comparative analysis for the obligatory investigations of these events. We confirmed deaths only under the age of 14, and in 90% of fatal accidents confirmed in SINAN there was some kind of delay in patient\2019s treatment. We conclude by the urgent need review of the logic to specific treatment referall centers implementation. The confirmed deaths in this study are concentrated between municipalities and populations that are among the poorest in the state, with the worst levels of inequality, low average schooling, living and working in regions with land use models that favor scorpionism and where insufficient working conditions do not allow systematic and permanent actions to this grievance. Applying models for analysis and coping neglected diseases, we verified that the peculiarities of our problem under study do not allow its approach by a stereotyped way, copied from other health problems, indicated the abandonment of scorpionism under the perspective of specific policies for its confrontation and sustaining attribution of negligence condition to the populations exposed to this aggravation in Rio de Janeiro.