[Fifteen years' experience in scorpion envenomation control in Algeria]. / Expérience de quinze années de lutte contre l'envenimation scorpionique en Algérie.

In Algeria, scorpion envenomation is real public health problem. Since the creation of the National Committee of Control of Scorpion envenomations (CNLES), several steps have been taken to deal with this problem. After a brief historical introduction, we present the main elements of the action carried out both in terms of treatment and of prevention of scorpion proliferation. The epidemiological situation is presented by stressing the difficulties involved in collecting reliable data. We also address the question of citizen and stakeholder awareness since public participation is crucial in all prevention programmes. Training for healthcare providers is also one of the principal axes of the Committee's programme which includes national, regional, and even local seminars. We describe the improvement of production and research on venoms carried out by the Institute Pasteur of Algeria. We conclude by discussing the action plan for 2001 and prospects for an enhanced strategy in the fight against the scorpion envenomation.

Round table and synthesis of the meeting.

Our knowledge of the epidemiology of scorpion stings and snakebites remains fragmentary but sufficient, nevertheless, to be able to confirm that envenomations constitute a real public health problem throughout Africa. In order for the health authorities to be able to improve management of this problem, data collection must be enhanced. The objective should be to determine what kinds of intervention are necessary (quantity of antivenom serum and drugs, in particular) and where they should be applied. Specialists must come to a rapid consensus for a simple therapeutic protocol to be used in peripheral health centres where means are often scarce. Training for health personnel is also insufficient. Appropriate courses must be organised for medical doctors and nurses within both their basic and on-going training. These courses must necessarily involve health personnel from rural zones must affected by envenomations. The availability of antivenom serum--the only specific, efficacious drug--must be improved as soon as possible. If quantitative and geographic needs can be determined by epidemiological studies, then distribution must be developed by original means (grouping orders at national level, direct orders) and diversified financial support (purchase on the open market, local authority grants, community participation). The symposium attendees agreed to meet again within two years' time to evaluate progress in the area.