Acute poisoning in the Rift Valley Provincial General Hospital, Nakuru, Kenya: January to June 2012

Clinical analysis of acute poisoning in children

OBJECTIVE

The clinical characteristics of hospitalized children with acute poisoning were analyzed to provide a reference for preventing poisoning and seeking effective prevention and treatment.

METHODS

The clinical data of 112 children with acute poisoning admitted to Qilu Hospital of Shandong University from January 1, 2018, to December 31, 2021, were collected and analyzed from different perspectives.

RESULTS

The majority of acute poisoning cases that occurred in children were in early childhood and preschool age (89 cases, accounting for 79.4%). The most common types of poisoning were pesticide poisoning and drug poisoning, and the main ways of poisoning were accidental administration via the digestive tract and accidental ingestion. Poisoning occurred slightly more in spring and summer all year round, and most children had a good prognosis after timely treatment.

CONCLUSION

Acute poisoning often occurs in children. Parental education and intensified child supervision are needed to prevent the incidence of unintentional poisoning.

Prevalence of unfavorable outcome in acute poisoning and associated factors at the University of Gondar comprehensive specialized hospital, Gondar, Northwest Ethiopia: a hospital-based cross-sectional study

Background

Acute poisoning is a medical emergency in which the toxic effects occur almost immediately, usually within hours from the time of exposure, and can result from exposure to excessive doses of any chemical. It is the common cause of emergency admission, which may result in morbidity and mortality. There are a lot of factors that are associated with an increased magnitude of mortality and complication. Therefore, this study was carried out to assess the clinical characteristics of patients, unfavorable outcomes of acute poisoning, and associated factors to improve the quality of care, resource utilization, and decrease mortality.

Objective

This study aimed to assess the outcome and associated factors among acute poisoning patients at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia (2021).

Methods

A prospective follow-up study was conducted from January 2021 to September 2021 at the University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia. Data were collected using a comprehensively organized and pretested interviewer-administered questionnaire. The data were entered using EPI data version 4.6.0 statistical software and then exported to Stata 14 for analysis. The data were analyzed for descriptive statistics. Statistical analysis was performed using bivariate and multivariate logistic regression models to identify factors associated with the unfavorable outcome of acute poisoning. The result is presented in the form of tables, figures, and text using frequencies and summary statistics such as mean, SD, median, IQR, and percentage.

Result

A total of 233 patients were included in the study. The prevalence of unfavorable poisoning outcomes in acute poisoning was 17.6% (95% CI: 13.2, 23.1). In the multivariate logistic regression analysis, known chronic medical comorbidities [AOR: 3.846 (1.619, 9.574); value of p: 0.014] and hospital stay of less than 48 h [AOR: 6.57 (2.03, 21.273); value of p: 0.002] were found to be independent factors associated with unfavorable outcomes in acute poisoning.

Conclusion

The magnitude of unfavorable poisoning outcomes was high in patients with acute poisoning. Having known medical comorbid illness and short hospital stay of less than 48 h were found to be associated with unfavorable outcomes.

Availability of Essential Antidotes and the Role of Community Pharmacists in the Management of Acute Poisoning: A Cross-Sectional Study in Ethiopia

Background

Morbidity and mortality related to acute poisoning is a major public health issue in both developing and developed countries. Community pharmacists have a crucial role in ensuring drug availability, increasing drug safety, counseling patients, overdose risk reduction and management, and provision of appropriate drug information. This study aimed to assess the availability of necessary antidotes in community pharmacies in Gondar and Bahir-Dar cities, Ethiopia, and the role of community pharmacists in the management of acute poisoning.

Methods

A cross-sectional survey was conducted in Gondar and Bahir-Dar cities. A self-administered, structured questionnaire was used for data collection and Statistical Package for Social Sciences (SPSS) version 24.0 was used for data analysis. Chi-square analysis was computed to identify the associated factors with a confidence interval of 95% and a P value less than .05 was used as a cut-point for statistical significance.

Results

Out of 101 community pharmacies invited to participate in the study, 80 of them completed the survey with a response rate of 79.2%. The overall mean antidote availability score was .59 (SD = .837), which falls within the definition of Poor availability. None of the pharmacies had kept all of the antidotes, and the maximum number of an antidote kept by a single pharmacy was 7 out of nineteen essential antidotes surveyed. The most commonly reported reason for the unavailability of essential antidotes was stock was not ordered (56.3%) followed by stock ordered but not delivered from suppliers (wholesalers) (20.0%). More than 3 fourth of the respondents (83.8%) had poor knowledge about the antidotes for the common poisonings.

Conclusion

There was a significantly very low availability of essential antidotes in the community pharmacies. Strategies should be implemented to improve pharmacist’s knowledge about antidotes, and management of poisoning emergencies through on-job training and provision of reference materials.

Epidemiological analysis of single center of acute poisoning cases based on poisoning treatment platform

ABSTRACT

To studied epidemiological characteristics of 493 cases of acute poisoning in Nantong city, Jiangsu province.Based on the analysis platform of poisoning treatment, adopted single center and prospective investigation method, analyzed data of acute poisoning patients from May 2015 to December 2018 in the second affiliated hospital of Nantong University.Among 493 patients with acute poisoning, men 227 (46.04%), women 266 (53.96%). Age ranged from 12 to 89 years old, average age 41.6 years. In the occupational distribution, farmers were 30.02%; 351 cases (71.20%) visited the hospital within 6 hours after exposure. Oral exposure poisoning 415 cases (84.18%). Pesticide poisoning accounted for 45.45% of deaths.Using the poisoning treatment platform to analyze the clinical characteristic had accurately and reliably in Nantong. The fatality rate of pesticide poisoning in cases of acute poisoning is high. Management of highly toxic pesticides should be continued and effective health education on pesticide use should be carried out.

Human health risk assessment of dichlorodiphenyltrichloroethane (DDT) and hexachlorocyclohexane (HCH) pesticide residues in fruits and vegetables in Nigeria

The residues of dichlorodiphenyltrichloroethanes (DDTs) and hexachlorocyclohexanes (HCHs) in forty-eight (48) composite fruit and vegetable samples (carrot, cucumber, tomato, and watermelon) were qualitatively and quantitatively determined using gas chromatography equipped with electron capture detector (GC-ECD). Safety indices such as the estimated average daily intake (EADI), cancer benchmark concentration (CBC), hazard quotient (HQ) and index (HI), and hazard ratio (HR) were also estimated. Results showed the predominance of HCH and its isomers in the fruits and vegetables as compared with the DDTs. The most predominant HCHs in all the fruits was α-HCH with mean concentrations of 2.704 ± 2.488 mg kg-1 (carrot), 1.536 ± 1.036 mg kg-1 (cucumber), 6.814 ± 2.967 mg kg-1 (tomato), and 9.241 ± 2.735 mg kg-1 (watermelon). The analysis showed that the levels of pesticide residues detected in 25 to 100% of the fruit and vegetable samples were above the UK/European Commission Maximum Residue Limits (MRLs). The non-carcinogenic health risk estimates showed that only α-HCH in tomatoes and watermelon had HQ > 1 which indicates the possibility of systemic health risk in children consumers. The carcinogenic health risk showed that only α-HCH and γ-HCH in children and α-HCH in adults had HR > 1 for tomato and watermelon which implies the possibility of carcinogenic health risk from its consumption. It is therefore paramount to institute a policy and regulatory framework for regular monitoring of pesticide residues in fruits and vegetables in Nigeria in order to ensure food safety for consumers and protect human health.

Prevalence, Predictors and Treatment Outcome of Acute Poisoning in Western Ethiopia

Background

Acute poisoning is a common reason for visiting the emergency department (ED) worldwide. However, little is known about this issue in the western part of Ethiopia. This study was carried out to determine the prevalence, predictors, and treatment outcome of acute poisoning at the ED of western Ethiopia.

Patients and Methods

A hospital record-based retrospective study design was conducted on all patients admitted to the ED of the two hospitals between 01 January 2018 to 17 March 2019. Socio-demographic, clinical presentation, medication history, poisoning characteristics, time to hospital arrival, treatment given, and outcome of treatment were collected. All collected data were analyzed using SPSS Version 20. Backward multiple logistic regression analysis at p-value ≤0.05 tested the predictor for treatment outcome.

Results

The prevalence of acute poisoning was 134/7883 (1.7%) per ED admissions. The mean ±SD age of the study participants was 23.90±10.606 with female to male ratio of 1:1.06. The most vulnerable patients to poisoning were individuals in the age range of 18 to 29 years 68/134 (50.7%) for both genders. Moreover, the most common poisoning agent was organophosphate 72/134 (53.7%). Besides, intentional poisoning was the most common 103/134 (76.9%) manner of poisoning with family disharmony 37/103 (35.9%) as the common reason. The case fatality rate of acute poisoning in the two hospitals was 2/134 (1.5%). The mean ±SD length of hospital stay was 1.86 ±0.943. The independent predictors of poor treatment outcome of acute poisoning were age ≥35 years [p-value= 0.049], female gender [p-value= 0.027], and hospital stay of >48 hours [p-value= 0.035].

Conclusion

The prevalence of acute poisoning in western Ethiopia is higher than the ever-reported data in Ethiopia. Thus, stakeholders should have to pay more attention to prevention and control strategies and appropriate handling of agrochemical substances to minimize their negative effects on this productive age group.

Acute pesticide poisoning amongst adolescent girls and women in northern Tanzania

BACKGROUND

Acute pesticide poisoning (APP) is reported to affect community health worldwide but its burden in Tanzania is unknown particularly in women. This study examines APP involving adult females and adolescent girls 10 to 19 years in 3 regions of Tanzania which are famous for coffee and vegetable production.

METHODS

Over the period of 12 months, health facility-based surveillance for cases of APP was implemented in 10 Tanzanian healthcare facilities in 2006.

RESULTS

The study identified 108 APP cases of whom 31 (28.7%) occurred amongst adolescent girls. Suicide was the leading poisoning circumstances (60.2%) and the most vulnerable women were 20-29 years old who comprised 38.4% of all cases with suicide as circumstance. Organophosphates (OPs), zinc phosphide, paraquat and endosulfan were common amongst known reported poisoning agents. The annual APP incidence, mortality and Case Fatality Rate for women were 5.1/100,000, 0.2/100,000 and 3.7/100, respectively.

CONCLUSION

APP amongst women in Tanzania is common and this call for diverse preventive interventions to reduce poisoning incidents.

Acute Poisonings at a Regional Referral Hospital in Western Kenya

The emergency department (ED) of the Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) handles many cases of poisoning. However, there is scant information on the factors, agents, and outcomes of poisoning at the hospital. The aim of this work was to determine the factors, agents, and outcomes of poisoning at JOOTRH. Records of patients who presented to JOOTRH with symptoms of poisoning between January 2011 and December 2016 were retrieved. Data on age, gender, offending agents, time, and season of exposure were collected. Information on the route of exposure, motive, and clinical symptoms of poisoning was also included. Other information included the laboratory evaluation, first aid measures, period of hospitalization, and outcome of poisoning. Mean, standard deviation, frequencies and bar graphs were used to describe the demographic factors of the study population. Multivariate logistic regression was used to determine the strength of association between risk factors and outcome of poisoning among patients. The level of significance for inferential analysis was set at 5%. There were 385 cases of poisoning: 57.9% (223/385) were male, 31.9% (123/385) were 13–24 years of age, and 83.9% (323/385) of exposures were in Kisumu County. The peak time of exposure was 6:00–00:00, and 23.6% (91/385) presented 1–4 h after exposure. About 62.9% (242/385) of the cases were due to accidental poisoning. Snakebites and organophosphates (OPPs) contributed to 33.0% (127/385) and 22.1% (85/385) of all cases, respectively. About 62.1% (239/385) of exposures were oral, and 63.9% (246/385) of all cases occurred in the rainy season. Additionally, 49.2% (60/122) of intentional poisoning was due to family disputes, and 16.1% (10/62) of pre-hospital first aid involved the use of tourniquets and herbal medicine. About 28.6% (110/385) of the victims were subjected to laboratory evaluation and 83.9% (323/385) were hospitalized for between 1–5 days. Other results indicated that 80.0% (308/385) responded well to therapy, while 7.3% (28/385) died, 68% (19/28) of whom were male. Furthermore, 39.3% (11/28) of the deaths were related to OPPs. Our findings suggest that the earlier the victims of poisoning get to the hospital, the more likely they are to survive after treatment is initiated. Similarly, victims of poisoning due to parental negligence are more likely to survive after treatment compared to other causes of poisoning, including family disputes, love affairs, snakebites, and psychiatric disorders. The management of JOOTRH should consider allocating resources to support the development of poison management and control.

Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016

OBJECTIVES

Up-to-date information on the patterns of acute poisoning is crucial for the proper management of poisoning events. The objectives of this study were to analyse the characteristics of patients suffering from acute poisoning admitted to the emergency department (ED) in a tertiary medical centre in Northeast China and to compare these characteristics with those of a previous comparable study.

DESIGN

Retrospective and descriptive study.

SETTING

Data were collected from the hospital information system in Shengjing Hospital, China, from January 2012 to December 2016.

PARTICIPANTS

All cases aged ≥11 years old with a diagnosis of acute poisoning.

RESULTS

In total, 5009 patients aged ≥11 years presented to the ED with acute poisoning during the study period. The average age of the patients was 36.0±15.1 years and over half (52.7%) were in the 20-39age group. The female to male ratio was 1.2:1. Patients with acute poisoning mainly lived in rural areas rather than in urban areas. The majority of patients consumed poison as suicide attempts (56.7%). Men were more commonly poisoned by drug abuse than women, but women outnumbered men in suicidal poisoning. The most common form of poison intake was ingestion (oral intake; 86.2%). The five most common toxic agent groups, in descending order, were therapeutic drugs (32.6%), pesticides (26.9%), alcohol (20.7%), fumes/gases/vapours (11.4%) and chemicals (3.6%). Sedatives/hypnotics in the therapeutic drugs group and paraquat in the pesticides group were the most common toxic agents, respectively. The mortality rate of study participants was 1.3%, with 64 deaths.

CONCLUSIONS

The results of this study indicate the need to strengthen education on the rational and safe use of drugs in Shenyang.

Acute poisonings during pregnancy and in other non-pregnant women in emergency departments of four government hospitals, Addis Ababa, Ethiopia: 2010-2015

OBJECTIVE

To characterise acute poisonings in pregnant and non-pregnant women treated at emergency departments of government hospitals in Addis Ababa, Ethiopia, between 2010 and 2015.

METHODS

All data for acutely poisoned women were retrospectively collected from patient medical charts at the emergency departments of Saint Paul's Hospital Millennium Medical College, Ras Desta Memorial Hospital, Yekatit 12 Hospital Medical College and Zewditu Memorial Hospital. Data were collected by extraction questionnaire and analysed using SPSSv. 20 statistical software.

RESULTS

During the study period, 998 cases of acutely poisoned women were listed in the hospital registries. Of these, complete data for inclusion in the study were available for 592. 36.3% of the study participants were in the age group of 20-24, with a mean (±SD) age of 23.03 (±6.3) years. 80.9% were from Addis Ababa; 4.6% were pregnant. The mean arrival time of all cases was 4.14 h. 85.5% of all study cases were due to intentional self-poisoning, of whom 42.1% were discharged without complications. The most common poisons were bleach and organophosphates; 25.9% of pregnant cases and 32.6% of non-pregnant cases were poisoned by bleach; and 18.5% of pregnant cases and 18.9% of non-pregnant cases had organophosphate poisoning. 0.7% had a history of poisoning; all were non-pregnant women. The common route of poison exposure was oral, and the case fatality rate of organophosphate poisoning in pregnant and non-pregnant women was 20 and 1.87%, respectively. The pre-hospital intervention for the majority of the women was milk, in 12.0% of cases.

CONCLUSION

Acute poisoning remains a public health problem in our community. Bleach is the most common poisons. Our present findings indicate the necessity of educational programmes on preventable reasons of acute poisonings and their outcomes on pregnant and non-pregnant women.

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened.

Pattern of acute poisoning in Jimma University Specialized Hospital, South West Ethiopia

BACKGROUND

Poisoning is a common cause of morbidity and mortality worldwide. People can be exposed to poisons either intentionally or accidentally. Designing appropriate treatment or prevention approaches depends on understanding of the nature and pattern of poisoning in a specific place. Information on the patterns of acute poisoning in Ethiopian hospitals is limited. This study was, therefore, conducted to evaluate the patterns of acute poisoning in Jimma University Specialized Hospital (JUSH), South West Ethiopia.

METHODS

A record based retrospective analysis of acute poisoning cases presented to JUSH from January 1, 2012 to December 31, 2013 was conducted. The collected data was analyzed using SPSS version 16.

RESULTS

Of the 103 patients, 49 (47.6%) were male and 54 (52.4%) were female. The highest prevalence of poisoning was observed in persons aged 12-20 years (70, 67.96%). Majority of the cases were intentional poisoning (52, 50.5%), and 28 (27.2%) of the cases were accidental. The common causes of poisoning were house hold cleansing agents (43, 41.7%), organophosphates (28, 27.2%) and drugs (13, 12.6%). Diarrhea and vomiting (49.5%), altered consciousness (16.5%) and epigastric pain (13.6%) were the common presenting symptoms.

CONCLUSION

Majority of the victims of the acute poisoning in this study were aged 12-20 years. The most common mode of poisoning was intentional poisoning resulting from temporary quarrel. The common poisons used by the victims were found to be household cleansing agents.