Além da picada: estudo predicativo do comportamento espaço-temporal dos acidentes provocados por escorpião no Estado da Bahia

Abstract

Scorpionism is recognized by the World Health Organization as a Neglected Tropical Disease and constitutes a serious public health problem in tropical countries, associated with an increasing number of cases and high morbidity and mortality. A review of the literature shows that, although there is an abundance of clinical and epidemiological studies, few works integrate environmental, climatic, and anthropogenic factors to understand risk patterns. This thesis aimed to analyze the evolution of scientific knowledge on scorpionism and, subsequently, to investigate the spatiotemporal patterns, environmental and social determinants, and priority risk areas in the state of Bahia, Brazil, between 2007 and 2022. Initially, a bibliometric review of 145 publications indexed in the Scopus database (1952–2022) was carried out, identifying authors, journals, collaboration networks, and the most frequent terms, in addition to evaluating the presence of environmental and anthropogenic variables in the studies. Subsequently, a retrospective observational study was conducted using SINAN data (2007–2022) from 417 municipalities in Bahia, integrated with socio-environmental indicators (IVS, IDA, land use and land cover, climatic variables). Spatial (LISA, MULTISPATI), temporal, and GAM modeling analyses were applied. The bibliometric survey demonstrated sustained growth in scientific production, with Brazil and Iran standing out as the most productive countries, but also revealed gaps in the association between scorpionism and environmental determinants, with most research focusing on clinical aspects. In Bahia, more than 200,000 cases were recorded during the study period, peaking in 2019 and predominating in urbanized areas. Persistent high-risk clusters were identified in the southcentral, southwestern, and far western regions, associated with unplanned urbanization, deforestation, agroindustry, and high social vulnerability. Multivariate analyses confirmed the relevance of climatic (thermal variation, precipitation, seasonality), environmental (degradation, pasture expansion), and social factors (IVS – human capital) as determinants of risk. Approximately 16% of the municipalities were classified as high priority for surveillance actions. The integration of bibliometric review and epidemiological analysis confirms scorpionism as an expanding health problem, still little explored from the perspective of environmental and social factors. The results reinforce the importance of interdisciplinary approaches and spatiotemporal analyses to understand its dynamics. It is concluded that effective public policies must integrate health, environment, urban planning, and sanitation in order to reduce structural inequalities and mitigate the impact of scorpionism, especially in tropical regions undergoing rapid socio-environmental transformation.