Scorpion sting envenomation: should it be considered a neglected tropical disease?

At least 2772 species of scorpion (Arachnida: Scorpiones Koch, 1837) have been described. Of these, only 104 species (3.8%) are medically relevant. Mexico has the highest biodiversity, with 12% of all scorpion species worldwide. Other countries with a high incidence of scorpion sting envenomation include Brazil, Iran and Morocco (Table 1). Despite the high incidence and the disproportionate number of cases in marginalized areas of the world, scorpion sting envenomation is not formally recognized as a neglected tropical disease (NTD) by the World Health Organization (WHO). However, snakebite envenomation is an official NTD according to the WHO, and PLOS (Public Library of Science) Neglected Tropical Diseases acknowledges that scorpion sting envenomation has many features that characterize NTDs.

The WHO defines NTDs as ‘a diverse group of conditions caused by a variety of pathogens (including viruses, bacteria, parasites, fungi and toxins) and associated with devastating health, social and economic consequences’. It states that ‘NTDs are mainly prevalent among impoverished communities in tropical areas … affect more than 1 billion people’ and that the ‘epidemiology of NTDs is complex and often related to environmental conditions … all these factors make their public health control challenging’. Scorpion sting envenomation meets all the criteria to be recognized as an NTD.