Scorpionism at the human-environment interface: an eco-epidemiological synthesis and conceptual framework

Area of Science:

• Public Health
• Environmental Science
• Ecology
• Epidemiology

Background:

• Scorpion envenomation is a major public health concern in tropical and subtropical regions.
• Its incidence is influenced by complex interactions between climate, ecology, socioeconomic status, and health systems.
• Existing research lacks a synthesized framework to understand these multi-level determinants.

Purpose of the Study:

• To develop an integrated conceptual model for understanding the determinants of scorpion envenomation.
• To organize the complex factors contributing to scorpionism risk and outcomes.
• To provide a framework for research, risk mapping, and intervention development.

Main Methods:

• Utilized Human Ecology Theory and socio-ecological systems thinking.
• Synthesized evidence from environmental science, climate impacts, scorpion biology, venom, epidemiology, and public health.
• Categorized over thirty determinants into six components: physical-climatic, scorpion ecology, venom, human exposure, health impacts, and socioeconomic factors.

Main Results:

• Developed a unified, systems-based conceptual model integrating diverse determinants of scorpion envenomation.
• The model clarifies pathways from upstream drivers to envenomation risk, clinical outcomes, and public health responses.
• Identified priority intervention points and a basis for empirical research and early-warning systems.

Conclusions:

• Adopting a socio-ecological systems perspective is essential for understanding and addressing scorpionism.
• The developed framework aids in hypothesis generation and interpretation, supporting targeted prevention strategies.
• Scorpionism should be recognized as a neglected tropical health condition due to its burden and socio-ecological determinants.