ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
STUDY OF ACCIDENTS CAUSED BY BOTHROPS AND BOTHROPOIDES IN TAPEROÁ,
PARAÍBA, BRAZIL
Joaci dos Santos CERQUEIRA¹, Douglas dos Santos OLIVEIRA², Marcela Tarciana Cunha Silva
MARTINS³, Helder Neves de ALBUQUERQUE4, Luciana da Rocha Oliveira CERQUEIRA5
1. Biólogo. Aluno da Especialização de Desenvolvimento e Meio Ambiental da FURNE: [email protected]
2. Graduando da Universidade Estadual da Paraíba, Curso de Ciências Biológicas
3. Professora Substituta do Curso de Ciências Biológicas do Departamento de Biologia, da Universidade Estadual da
Paraíba
4. Biólogo. Instituto Bioeducação - IBEA
5. Graduanda da Universidade Estadual da Paraíba, Curso de Enfermagem
ABSTRACT: Accidents with snakes reported in the city of Taperoá, in the state of Paraíba, Brazil,
rank second place of all snake accidents reported in Paraíba. The snakes that cause the most
accidents are of the Bothrops and Bothropoides genera. The objective was to analyze the perception
and approach adopted by the victims of snake bites in Taperoá, Paraíba. We used semi-structured
interviews with those injured by snakes in the city, assessing the following items: anatomical area
affected, age, gender, profession, average time in medical care after the accident, first aid or
treatment alternatives, signs and symptoms after the bite, and sequel of the accident. We
interviewed 36 injured people, according to the details given by the city residents about those who
had been bitten by a snake species. The results showed that accidents with pit vipers were more
frequent in males; the most frequent age was between 41 and 50 for men and for women between
26 and 30. As to their occupations, most were farmers. As to the anatomical region of the bites, the
upper limbs accounted for the majority of the cases. The average time in healthcare services was
between 0 and 4 h. In relation to alternative treatments, 25% used folk healers and / or taboos /
customs of the region. The main signs and symptoms were headaches and dizziness, and as to
sequel, about half those interviewed listed headaches as the main one.
Keywords: Bothropoides erythromelas, Folk healers, Beliefs.
RESUMO: Os acidentes com serpentes notificados no município de Taperoá-PB ocupa a segunda
colocação no Estado na Paraíba. As serpentes que causam mais acidentes são dos gêneros Bothrops
e Bothropoides. O objetivo foi analisar as percepções e condutas adotadas por vítimas de acidentes
ofídicos em Taperoá-PB. Utilizou-se entrevistas semi-estruturadas com os acidentados por
serpentes no município, avaliando os seguintes itens: região anatômica acometida, faixa etária,
gênero sexual, profissão, média de tempo no atendimento médico após o acidente, primeiros
socorros ou tratamentos alternativos, sinais e sintomas após a picada e as sequelas do acidente.
Foram entrevistadas 36 pessoas acidentadas de acordo com a indicação dos residentes na cidade que
havia sido picado por alguma espécie de serpente, com isso os resultados obtidos evidenciaram que
os acidentes com jararacas apresentaram-se mais frequentes no gênero masculino; a faixa etária
mais frequente foi entre 41 a 50 para homens e 26 a 30 para mulheres; quanto a ocupação a maioria
eram agricultores; quanto a região anatômica os membros superiores representaram a maioria dos
casos; a média de tempo no atendimento foi entre 0 e 4h; em relação ao tratamento alternativo 25%
usaram as rezadeiras/curandeiras e/ou tabus/costumes da região; quanto aos sinais e sintomas os
principais foram dores de cabeça e tonturas; em relação as sequelas a metade dos entrevistados
apontaram a dor de cabeça como a principal sequela.
Palavras-chave: Bothropoides erythromelas, Rezadeira, Crença.
1
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
1. INTRODUCTION
In Brazil, there are about 250 species of snakes, 180 of these are non-poisonous and 70
considered poisonous. Only two snake families are considered poisonous: the Viperidae family,
with emphasis on the Crotalinae subfamily, which the Caudisona (Rattlesnake), Bothrops and
Bothropoides (Jararacas) and Lachesis (Bushmaster - Sururucu) genera belong to; and the Elapidae
family, which includes of the genus Micrurus, whose species are known as true coral snakes
(MELGAREJO, 2003).
In the state of Paraíba, snakes of the Bothrops and Bothropoides genera are responsible for
more than 90% of the reported accidents (OLIVEIRA et al., 2010).
In ophidian accidents, the diagnosis is usually based on the observation of the symptoms
and signs present in the victims because of toxic activity, and developed due to the inoculation of
the specific poison. Current knowledge of the poison composition and its main effects over the
human organism allow the physician to recognize the genus of the animal involved in the accident
and select the adequate antidote, even in the absence of the snake (AZEVEDO, CUPO and
HERING, 2003).
The absence of basic care, the lack of information, ignorance, and furthermore, negligence,
to ophidian accidents, affects a great number of cases, mainly in rural areas. Accidents mainly tend
to be linked to two factors: climatic conditions and exposure of the population to the agents causing
the accidents. For adequate treatment of the accidents, it is initially important to classify if the snake
is or not poisonous, so as to apply the specific serum (PIRES, 2004).
In the Northeast Region of Brazil, accidents involving snakes are still a taboo when speaking
of treatment. Occasionally, first aid is performed erroneously, and the adequate treatment with
antidote serum is far away from the places where most of the accidents occur, usually being mostly
found in medium-sized and large cities (ALBUQUERQUE, 2002).
Studying ophidian accidents provoked by snakes of the genus Bothrops, and the ophidian
accidents reported in the state of Paraíba, it was found that the accidents began to be registered and
filed in the CEATOX (Center of Assistance and Toxicological Information) Regional Health
Centers in the city of João Pessoa, Paraíba, in 1995 and in the CEATOX in the city of Campina
Grande in the year of 1999, when it was inaugurated. It can be noted that, although it is a
requirement to report ophidian accidents in Brazil since 1987, in Paraíba, these notifications only
began to be filed in 1999. It is also important to state that the high rate of ignored and/or not
reported data suggests that it is not possible to trace a coherent clinical-epidemiological profile of
2
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
Bothrop accidents in the state of Paraíba (ALBUQUERQUE, COSTA and CAVALCANTI, 2004;
ALBUQUERQUE, FERNANDES and ALBUQUERQUE, 2005). However, most of the accidents
are caused by Bothrops leucurus, Bothropoides neuwiedi and Bothropoides erythromelas species
(OLIVEIRA et al., 2010).
As to the accidents reported during the period between January and December of 2005, by
the CEATOX in Campina Grande, Paraíba, 727 cases were reported, and the cities in Paraíba with
the highest number of occurrences of accidents were Campina Grande (10.8%), Taperoá (6.8%),
Soledade (6.4%), Boa Vista (4.3%) and Barra de Santana (4.1%), and all of the rest, 4% (LEMOS et
al., 2009).
Thus, this research aimed to analyze the perception and conduct adopted by victims of
ophidian accidents with Bothrops and Bothropoides genera in the city of Taperoá, Paraíba.
2. MATERIAL AND METHODS
This was a descriptive field study, of participating and exploratory character, and qualitative
and quantitative approach, performed in the city of Taperoá, in the interior of the state of Paraíba,
localized 216 km from the capital, bordered on the north by the cities of Salgadinho, Passagem and
Assunção, on the east by Juazeirinho and Gurjão, on the west by Desterro, Passagem, Teixeira, and
on the south by Livramento, and São José dos Cordeiros. Taperoá has a territory of 639.96 km², an
average altitude of 532 meters and a population estimated at 15.236 inhabitants, most of them in
rural areas (IBGE, 2010).
The study was composed by 36 persons of both sexes, which was the maximum number of
victims of ophidian accidents diagnosed as bothropic. These people were all residents of urban and
rural areas of Taperoá.
Data collection was conducted in the period between January 2011 and June 2011, from
victimized residents, according to information provided by the residents of Taperoá themselves, all
of them aged between 18 and 90 years. Interviews were conducted in order to collect the data about
the experiences involving snake accidents with Bothrops and Bothropoides genera, as well as about
alternative treatments adopted by the victims.
Exclusion criterion was adopted for the individuals who were proved not to be victims of
ophidian accidents.
3
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
The instrument used for data collection was an interview script. Data were analyzed and
interpreted at the end of the collection period, and displayed in individual graphs and or tables,
through the Microsoft Word 2010 program.
An informed consent form was used, respecting the principle of autonomy and dignity,
thus protecting the participants of the research in their vulnerability, committing to maximum
benefit and minimum damage and risks (beneficence), and guaranteeing to prevent foreseeable
harm (no maleficence), according to resolution 196/96 of the Health Ministry (BRASIL, 1996).
This work was approved by the Ethics and Research Committee (CEP) of the Paraíba State
University as well as by the CAEE (Certificate of Presentation for Ethics Appreciation) under the
number of 0625.0.133.000-10 on December 14, 2010.
3. RESULTS AND DISCUSSION
The city of Taperoá was chosen because according to the occurrences registered at the
CEATOX (Center of Assistance and Toxicological Information) in Campina Grande, Paraíba, this
city ranks second place in the state of Paraíba as to reports of occurrences involving accidents with
poisonous snakes, and most of these (91.7%) of the Bothrops and Bothropoids genera (LEMOS et
al., 2009; OLIVEIRA et al., 2010).
According to the results of the interviews, the greatest age frequency was between 41 and
50 for men and 26 and 30 for women, and as to the gender of the victims in the city of Taperoá, the
highest incidence of reports was for men, with 27 cases (75%) (Table 1).
Table 1: Distribution of snake bites, according to age and sex of victims in the city of
Taperoá, Paraíba, 2011.
Gender
Age Range
Male
Female
Total
(years)
number
%
numbe
%
number
%
r
18 a 20
1
2.77
1
2.77
21 a 25
1
2.78
1
2.77
26 a 30
2
5.56
4
11.11
6
16.66
31 a 40
4
11.11
2
5.56
6
16.66
41 a 50
8
22.22
8
22.22
51 a 60
2
5.55
2
5.55
61 a 70
4
11.11
2
5.56
6
16.66
71 a 80
4
11.11
4
11.11
81 a 90
2
5.56
2
5.55
Total
27
75
9
25
36
100
4
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
The occurrence of ophidian accidents in the city of Taperoá, Paraíba, follows the same
tendency of other areas in the state of Paraíba (ALBUQUERQUE, COSTA and CAVALCANTI,
2004; ALBUQUERQUE, FERNANDES and ALBUQUERQUE, 2005; OLIVEIRA, et al., 2010).
Analyzing the sex of the patients, Fonseca (2009) revealed that accidents with snakes
usually happen to males (63.26%) between 10 and 34 years of age, according to the epidemiological
survey of accidents caused by poisonous animals in the semiarid region of the state of Rio Grande
do Norte, Brazil, in the period from 2000 to 2008. These data do not differ from those found in a
study about the profile of ophidian accidents in the north of the state of Minas Gerais (LIMA,
2009), which also verified that most of the individuals affected by ophidian accidents were between
20 and 34 years of age (24.5%), and the lower age group reached 39.7% of the total, and 53.1% of
the patients were male.
In relation to the occupations performed by the victims of ophidian accidents (Table 2),
most of the men (55.56%) and women (16.66%) were farmers, totaling (72.22%). Both sexes (22,
22%) performed other occupations, Homemakers (2.78%) and 2.78% did not inform their
occupations.
Table 2: Distribution of snake bites according to occupation and gender
of victims in the city of Taperoá, Paraíba, 2011.
Gender
Male
Female
Total
Professions
number
%
number
%
number
%
Farmer
20
55.56
6
16.66
26
72.22
Homemaker
1
2.78
1
2.78
Other
6
16.66
2
5.56
8
22.22
Did not inform
1
2.78
1
2.78
Total
27
75
9
25
36
100
When the epidemiological profile of the ophidian accidents happening in the city of Juiz de
Fora, in the state of Minas Gerais, were conducted, the genus Bothrops was responsible for 68% of
the cases and the individuals afflicted were mainly male (76.8%) between the ages of 16 and 60
(57.8%) (BARRETO, 2010). These data corroborate studies performed in the state of Paraíba
(ALBUQUERQUE, COSTA and CAVALCANTI, 2004; ALBUQUERQUE, FERNANDES and
ALBUQUERQUE, 2005; OLIVEIRA et al., 2010) and the city of Rio Branco, in the state of Acre
(Moreno, 2005), where most of the bites committed rural farmers. Generally, rural male workers
statistically predominate among victims of poisonous snakes. In this study was also confirmed that
of 665 accidents, 16.5% were with snakes of the genus Bothrops with rural worker (n = 665, 16.5%)
(MISE, SILVA e CARVALHO, 2007). These results agree with those found at the city of Juiz de
5
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
Fora, Minas Gerais (BARRETO, 2010), during the period between 2002-2007, in which ophidian
accidents occurred mostly with males in active age. Most of these accidents were caused by snakes
of the genus Bothrops, and most of the bites occurred on the lower limbs, mainly on the feet.
Farming requires constant usage of upper and lower limbs, making these parts of the body
vulnerable to accidents involving snakes. According to the data shown in Table 3, in both sexes,
upper limbs totalized (72.22%) of the cases, followed by (25%) of lower limbs, and in all other
locations, there was only 1 case referring to a male.
Those interviewed mentioned suffering the bites while removing tree branches or when
introducing hands into holes or debris. One 40-year-old woman said that she suffered the accident at
dusk, while walking to her neighbor’s house, and that as she was going through a path near bushes,
she was bitten. She says: “My boy had a lantern and was walking and pointing to birds in the
bushes. He forgot to look at the ground, and then I felt the bite. When I looked, my boy said: mom,
let me check. He looked and said it was a snake. I walked away, afraid that it might be a
rattlesnake, because I think rattlesnakes are the most dangerous.”
Table 3: Distribution of snake bites, according to the area of the bite of
victims in the city of Taperoá, Paraíba, 2011.
Gender
Anatomical area
Male
Female
Total
attacked
nº
%
nº
%
nº
%
Upper limbs
20
55.56
6
16.66
26
72.22
Lower limbs
5
13.89
4
11.11
10
25
Other
1
2.78
1
2.78
Total
26
72.22
10
27.78
36
100
The same tendency was confirmed in a study for the northwest region of the state of São
Paulo (ROJAS, GONÇALVES and ALMEIDA, 2007), where accidents involving ophidians were
mostly on the lower (67.2%) and on the upper (30.5%) limbs. In this study, one accident in the
region of the head, caused by of the genus Bothrops, and one in the region of the torso, caused by a
non-identified species, were registered.
As to the average time spent being seen by the physician and with the identification of the
animal that caused the accident, it is a main tool of efficacy to reduce the sequela left by the action
of the poison in the human body. According to the data shown in Table 4, the average time that
most of the participants spent being seen was between 0 and 2h and 2 to 4h (45.45%) for both time
groups, and a small percentage (9.1%) spent 4 to 6h.
As to signs and symptoms in the victims, most (77.78%) declared having headaches,
dizziness among other symptoms, and the others (22.22%) did not present any sign or symptom.
6
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
After inoculation of the poison, its action is immediate and characterized by variable pain,
erythema and signs of inflammation, which might expand throughout the limb in the following
hours, causing equinoxes and boils in the next days. Hemorrhagic activity is caused by the poison,
which is capable of activating coagulation factors, depredating the fibrinogen, and causing blood
incoagulability. In 33.3% of the patients evaluated this alteration happened. Still, the coagulation
problem is the most common systemic manifestation, clinically manifesting itself by bleeding far
from the wounds caused by the inoculating fangs, thus confirming incoagulability and
thrombocytopenia (OLIVEIRA et al., 2008).
As to sequela left after healing from the ophidian accident, half of those interviewed said
headache was the main sequel, followed by 44.44% who revealed having no sequelae and still, a
minority who had itching in the area where the bite occurred.
In relation to sequelae linked to ophidian accidents, such as, for example, headaches, there
is a tendency of these victims to have sinus infections, without any cause-effect, after accidents
involving snakes.
Table 4: Distribution of snake bites according to those interviewed in the city of Taperoá, Paraíba, and medical
care after the accident, alternative treatments, symptoms and sequels, 2011.
Gender
Male
Female
Total
Items related to accidents with snake bites
number
%
number
%
number
%
Average length of time between the
accident and hospital service
0 a 2h
2
5.56
8
22.22
10
27.78
2 a 4h
10
27.77
10
27.77
4 a 6h
2
5.56
2
5.56
Ignored
9
25
5
13.89
14
38.89
23
63.89
13
36.11
36
100
Total
Use of alternative treatment
12
85.71
2
14.29
14
100
(prayers by folk healers and other)
Symptom
Ignored
6
16.67
3
8.33
9
25
Edema
4
11.11
3
8.33
7
19.45
Bleeding
3
8.33
3
8.33
Ecchymosis
3
8.33
1
2.78
4
11.11
Pain
3
8.33
3
8.33
Headache
2
5.56
3
8.33
5
13.89
Boils
2
5.56
2
5.56
Diplopia
1
2.78
1
2.78
Fainting
1
2.78
1
2.78
Necrosis
1
2.78
1
2.78
Total
26
72.22
10
27.78
36
100
Sequels
Headache
14
38.89
4
11.11
18
50
Itching around the bite
2
5.56
2
5.56
No sequelae
10
27.77
6
16.67
16
44.44
Total
26
72.22
10
27.78
36
100
7
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
These data corroborate the epidemiological profile study of ophidian accidents in the city
of Juiz de Fora, Minas Gerais, which relates the use of the serum and the time between the bite and
medical attention as important factors. It was noted that 22.4% of the victims had been seen at a
hospital service by 1 hour after the accident and that the other 47.3% had been seen between 1-3
hours after the accident with snake bites. Still 11.2% had treatment between 3-6 hours; 4.8%
between 6-12 hours and 7.1% above 12 hours (BARRETO, 2010). This also corresponds to our
research, where 82.8% of the patients were attended within the first three hours, with 223 accidents
treated in the first hour and 174 between one and three hours (ROJAS, GONÇALVES and
ALMEIDA, 2007).
These results confirm the study on Ethno-zoology as a tool for teaching biology, because
of reports of victims involving snakes, when two of the individuals interviewed stated that they
used alternative solutions, such as herbs, blessings, prayers, or superstitions (PEDERSOLI, 2008).
This tendency was also seen in a study involving snakes of the genus Bothrops in the state
of Bahia, in which a tourniquet was used as an initial intervention 59 (8.9%) cases, and in 11 of the
accidents (1.7%) patients reported using popular medicinal resources previous to medical services
(MISE, SILVA and CARVALHO, 2007).
In the accidents involving Bothrops jararaca, the clinical manifestations around the bite
area were systemic edema, renal failure and hemorrhaging (BOCHNER and STRUCHINER, 2003).
As to the clinical and epidemiological aspects in the accidents caused by Micrurus
registered at the center of toxicological information in the state of Santa Catarina, it was inferred
that all the options of treatment utilized by the victims of snake accidents obtained 100% efficacy in
the group of patients that had symptoms (specific serum therapy, inhibitors of cholinesterase and
mechanical ventilation) and that the evolution of the patients was 100% healing, without sequelae
(RODRIGUES, 2006).
In the epidemiological survey of accidents with poisonous animals in the semiarid region
of the state of Rio Grande do Norte (FONSECA, 2009), it was verified that in ophidian accidents,
evolution was favorable, with 83.7% (n= 123) healing and only 0.6% (n= 1) with sequela after
being seen at a medical/hospital service.
In the study about the comparison between the epidemiology of the accident and the
clinical findings of poisoning by snakes of the genus Bothrops, in elderly or non-elderly adults, it
was verified that older individuals are more commonly bitten on the upper limbs (hands) than on the
8
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
lower limbs (feet) and that their cases more frequently evolve to necrosis of the bite area and to
renal failure than in younger individuals (RIBEIRO, GADIA and JORGE, 2008).
In relation to using alternative treatments such as prayers/folk healers, 38.88% of those
interviewed, 33.33% male and 5.55% female mentioned utilizing these procedures.
According to the ophidian accident victim interviews in Taperoá, Paraíba, the data
broached in the interviews are shown in (Picture I) with respect to: concept of poison; recognition
of poisonous snakes; measures to be taken after an accident involving snakes.
Picture 1: Concepts of the victims of accidents with snake bites in Taperoá, Paraíba, 2011.
Questions
What is Venom?
How do you
recognize a
venomous
(poisonous) snake?
Measures taken
after the accident
involving snake
bites
Popular Concepts
“it’s when a snake has poison”
“I don’t know”
“it’s when a snake is bad for us”
“I don’t know how to recognize one”
“by its pattern, color and aggressiveness”
“it keeps lunging without stopping, and it has a thin tail”
“by its coloring”
“it has a thin nozzle, it’s sort of white, its head is flat and thin tail”
“I immediately went to a folk healer near my house”
“they took me to a medical clinic in Taperoá immediately, I was sent to Campina Grande”
“I used a lighter and burnt the place of the bite and then went to be prayed for”
“in despair after the snake bite I found a folk healer to pray for me, then he asked me if I was
disgusted by his spit, and when I said no, he spit into my mouth and then prayed for me”
“I didn’t go to a doctor nor to a folk healer because I am a folk healer and snakes don’t do me any
harm”
“I am a folk healer, I’ve been bitten more than 20 times, I pray for myself when I am harmed”
“I went to a folk-healer, and soon I could see again. I spent seven days locked in my bedroom in the
dark and my finger rotted and fell off”
“The folk healer told me to take a mixture of tea with dirt from my footsteps and from the place
where the snake passed, the day after he prayed over me, I was well”
“after the bite I fainted, som y cousin took me straight to Campina, right away I was put on an IV!”
It can be concluded that accidents involving the Bothrops and Bothropoides genera in the
city of Taperoá, Paraíba, showed negative aspects as to the form of prevention, treatment and
prophylaxis of a great number of cases occurring in this city.
The lack of information about snakes, and furthermore, the local traditions which are full
of taboos and beliefs about alternative treatments for accidents involving snakes, in particular
Bothrops and Bothropoides, are a reality that afflict Taperoá, Paraíba.
Those interviewed still perform alternative treatments, and don’t seek medical help,
instead, they go for local folk healers, and also believe they are immune to snake bites, since they
have been bitten several times.
9
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
The number of cases of ophidian accidents in Taperoá should be treated as a case of public
health, because this city is far from aid and treatment for these accidents (antidote serum) and
because of its population’s belief that the local folk healers are efficient for accidents with snakes.
Thus, further campaigns by the proper Institutions and public agents are recommended so
as to eradicate alternative treatments for the accidents with the jararaca, of the Bothropoides and
Bothrops genera.
4. CONCLUSIONS
It is concluded that accidents involving Bothropoides erythromelas the municipality of
Taperoá-PB present negative aspects regarding the way prevention, treatment and prophylaxis of a
large number of cases occurred in the county.
The lack of information on the snakes, and even the local culture that is steeped in taboos
and beliefs directed to alternative treatments with accidents involving snakes, particularly the genus
Bothropoides erythromelas are a reality afflicting Taperoá-PB. It should be emphasized that
Taperoá is the second municipality in numbers snakebites CEATOX registered in the Campina
Grande-PB, that is dangerous, since 38.89% of respondents said they held alternative treatments do
not seek medical aid sought praying person site, and also believed to be immune to snake bites in
order that has already been chopped several times. Regarding the consequences linked to snake
bites, such as headache, there is a tendency for such victims having sinusitis, and there is no cause
and effect with those accidents involving snakes.
The numbers of cases in Taperoá should be treated as a case of public health, since this city
is distant from the point of rescue and treatment of accidents (antivenom) and finally by the belief
that people exist, that local healers are effective as accidents with snakes. Therefore, we propose
more campaigns by the institutions and the public, in order to eradicate alternative treatments
involving accidents with jararaca Bothropoides erythromelas.
5. ACKNOWLEDGMENTS
To Francisco Ramos de Brito, for the affection and motivation in this study.
6. REFERENCES
ALBUQUERQUE, H. N.; FERNANDES, A.; ALBUQUERQUE, I. C .S. Snakebites in Paraíba,
Brazil. J Venom Anim Toxins Incl Trop Dis. 2005, 11, 242-51.
10
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
ALBUQUERQUE, H. N. Perfil clínico-epidemiológico dos acidentes ofídicos notificados no
Estado da Paraíba. Dissertação (Mestrado).Campina Grande: Universidade Estadual da Paraíba e
Universidade Federal da Paraíba, 2002. 145p.
ALBUQUERQUE, H. N.; COSTA, T. B. G.; CAVALCANTI, M. L. F. Estudo dos acidentes
ofídicos provocados por serpentes do gênero Bothrops notificados no estado da Paraíba. Revista de
Biologia e Ciências da Terra, 2004, 5, 18-26.
AZEVEDO, M. M.; CUPO, P.; HERING, S. E. Acidentes por animais peçonhentos: Serpentes
peçonhentas. 2003, 36, 480-89.
BARRETO, B. B.; SANTOS, P. L. C.; MARTINS, F. J.; BARBOSA, N. R.; RIBEIRO, L. C.;
LEITE, I. C. G.; VIEIRA, R. C. P. A. Perfil epidemiológico dos acidentes ofídicos no município de
Juiz de Fora-MG, no período de 2002-2007. Rev. APS. 2010, 13, 2, 190-95.
BOCHNER, R.; STRUCHINER, C. J. Epidemiologia dos acidentes ofídicos nos últimos 100 anos
no Brasil: uma revisão. Cad. Saúde Pública. 2003, 19, 1, 7-16.
BRASIL. Conselho Nacional de Saúde. Resolução nº 196, 10 de out.1996.
FONSECA, Z. A. A. S. levantamento epidemiológico dos acidentes por animais peçonhentos no
semi-árido do Rio Grande do Norte, Brasil: 2000 a 2008. Acta Veterinaria Brasilica. 2009, 3, 3,
127-31.
BRASIL. IBGE Cidades, Taperoá. Abril de 2005. Disponível em:
<http://www.ibge.gov.br/cidadesat/ painel/ painel.php?codmun=251650>. Acesso em: 30 de out.
2010.
LEMOS, J. C.; ALMEIDA, T. D.; FOOK, S. M. L.; PAIVA, A. A.; SIMÕES, M. O. S.
Epidemiologia dos acidentes ofídicos notificados pelo Centro de Assistência e Informação
Toxicológica de Campina Grande (Ceatox-CG), Paraíba. Rev. Brás. epidemiol. 2009, 12, 32-41.
LIMA, J. S. Perfil dos acidentes ofídicos no norte do Estado de Minas Gerais, Brasil. Revista da
Sociedade Brasileira de Medicina Tropical, 2009, 42, 5, 561-64.
MELGAREJO, A. R. Serpentes Peçonhentas do Brasil. In: Cardoso, LC et al. Animais Peçonhentos
no Brasil: biologia, clínica e terapêutica dos acidentes. São Paulo: Savier, 2003: 33-61.
MISE, Y. F.; SILVA, R. M. L.; CARVALHO, F. M. Envenenamento por serpentes do gênero
Bothrops no Estado da Bahia: aspectos epidemiológicos e clínicos. Revista da Sociedade
Brasileira de Medicina Tropical, 2007, 40, 5, 569-73.
MORENO, E. Características clínico epidemiológicas dos acidentes ofídicos em Rio Branco, Acre.
Revista da Sociedade Brasileira de Medicina Tropical. 2005, 38, 15-21.
OLIVEIRA, F.N.; BRITO, M. T.; MORAIS, I. C. O.; FOOK, S. M. L.; ALBUQUERQUE, H. N.
Accidents caused by Bothropoides e Bothrops in the Paraíba State: epidemiological and clinical
aspects. Revista da Socieade Brasileira de Medicina Tropical, 2010, 43, 6, 662-67.
PEDERSOLI, T. F. Etnozoologia como ferramenta para o ensino de biologia: unindo os saberes
para a aprendizagem. Educação e Diversidade. 2008, 181-222.
PINHO, F. M. O.; PEREIRA, I. D. Ofidismo. Rev Ass Med Brasil, 2001, 47, 1, 24-29.
PIRES, L. S. Estudo Epidemiológico de acidentes ofídicos na cidade de São José dos Campos (SP)
e municípios adjacentes. São José dos Campos: Dissertação (Mestrado) Universidade do Vale do
Paraíba, 2004. 74p.
11
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413
ISSN 2179-4413
Volume 3 / Número 1/ Jan/Mar - 2012
RIBEIRO, L. A.; GADIA, R.; JORGE, M. T. Comparação entre a epidemiologia do acidente e a
clínica do envenenamento por serpentes do gênero Bothrops, em adultos idosos e não idosos. Rev.
Soc. Bras. Med. Trop. 2008, 41, 46-49.
RODRIGUES, C. K. Aspectos clínicos e epidemiológicos dos acidentes por Micrurus registrados
no centro de informações toxicológicas de Santa Catarina-SC. Florianópolis: Universidade Federal
de Santa Catarina. 2006. 44p.
ROJAS, C. A.; GONÇALVES, M. R.; ALMEIDA S. M. Epidemiologia dos acidentes ofídicos na
região noroeste do estado de São Paulo, Brasil. Rev. Bras. Saúde Prod. 2007, 8, 3, 193-204.
12
CERQUEIRA, J. S.; OLIVEIRA, D. S.; MARTINS, M. T. C. S.; ALBUQUERQUE, H. N.; CERQUEIRA, L. R. O.
Study of accidents caused by Bothrops and Bothropoides in Taperoá, Paraíba, Brazil. Revista Brasileira de
Informações Científicas. v.3, n.1, p. 1-12. 2012. ISSN 2179-4413