SCORPION STINGS AS A NEGLECTED HEALTH ISSUE IN LOWER DIR, PAKISTAN: A FIRST EPIDEMIOLOGICAL REPORT

Abstract

Scorpionism is a major health issue in the tropics and subtropics of the world; this phenomenon accounts for around 1.2 million stings and 3250 deaths each year. Although Pakistan is a subtropical country heavily affected by scorpion stings, no previous study has examined scorpion stings in Lower Dir District. This study aimed to investigate, for the first time, the distribution and pattern of scorpion sting cases in District Dir Lower, Khyber Pakhtunkhwa, Pakistan. We conducted a cross-sectional analytical study across seven tehsils over 29 months. Data were collected retrospectively from health records and prospectively through structured online interviews and questionnaires, detailing demographic variables, circumstances of stinging, sting location, and clinical features. In total, 426 confirmed cases of scorpion stings were recorded. Women (57.3%) were affected more often than men (42.7%), and the most affected age group was 16-35 years. Most cases occurred at night or early morning (96.0%) and mostly in the summer months, when the number of cases was significantly related to temperature (p < 0.00013). The foot was the most affected body part, followed by the hand, and the victim's age was significantly associated with the sting site (χ² = 17.84, p = 0.007). Most victims (93%) experienced only local signs of envenomation, and only 46 patients developed systemic symptoms, while only 9 patients experienced the most dangerous signs, including tachycardia and respiratory problems. No fatalities were recorded. Munda tehsil had the highest number of sting cases (21.4%). Only 46% of the victims received medical treatment. Scorpion stings pose a significant health challenge in District Dir Lower, particularly for rural populations with poor access to healthcare. With limited access to medical facilities and antivenom in this rural region, public health initiatives must be improved.