Accidental Childhood Poisoning in Enugu, South-East, Nigeria

Patterns and clinical outcomes of childhood poisoning presenting to a children's emergency department in Yenagoa, Nigeria: a 10-year retrospective study

INTRODUCTION

Background: Childhood poisoning, characterised by exposure to toxic substances, poses a global health concern with variations across regions. Despite the importance of having current information about childhood acute poisoning in our region, there is a noticeable gap in such research in our local context. Regularly reviewing the agents responsible for poisoning in our locale is essential for devising prevention strategies and treatment approaches. This study aimed to examine the patterns and outcomes of childhood poisoning at the Children's Emergency Department of the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.

METHODS

A retrospective cross-sectional study was conducted, analysing cases of childhood poisoning in the Children's Emergency Ward, presenting from January 2013 to December 2022. Sociodemographic data, types of poisoning agents, home interventions, clinical features and outcomes were extracted from medical records.

RESULTS

Of 9389 admissions, 81 (0.8%) cases were admitted for childhood poisoning, but only 69 cases were analysed (total n=69). Children aged under 5 years (52.2%) and who were males (59.4%) were mostly involved. Organophosphates (21.7%) and kerosene (20.3%) were common poisoning agents, often accidental (72.5%) and occurring at home (94.2%). Delayed hospital presentation (>2 hours) was common (68.1%). Vomiting (72.5%) and drooling saliva (56.5%) were prevalent symptoms. Hydration (60.9%) was the main hospital intervention, while antidotes were infrequently used (15.9%). Mortality was 8.7%, predominantly due to kerosene ingestion in young children.

CONCLUSION

Organophosphate and kerosene poisoning are the most common in this facility. Enforcement challenges persist, emphasising the importance of safe storage practices and improved poison control measures. Addressing resource constraints for antidote availability and increasing awareness are vital for effective management and prevention.

Accidental kerosene oil ingestion in under-five age children in Nigeria - The need for vigilance in primary care settings in low- and middle-income countries (LMICs)

Four children aged between 15 months and two years presented in several different out-patient emergency departments with a history of recent ingestion of kerosene. Majority of the patients lived in crowded domestic settings, and they all presented with varying degrees of respiratory distress, different presentations of respiratory clinical symptoms and signs, after being subjected to various potentially dangerous home remedies to counter the effect of the kerosene. Majority of the children presented late, but all recovered following appropriate management. The presented cases demonstrate the vital importance of prompt emergency management in primary care settings, family counseling on childcare and domestic safety, and community enlightenment on reducing the complications and frequency of childhood poisoning in increasingly overcrowded and less affluent communities.

Systematic review and single-centre toxicology study identified analgesics and benzodiazepines as the main causes of paediatric medication poisoning

AIM

This study evaluated medication poisoning in paediatric patients through a systematic review and a retrospective documentary analysis in a Brazilian toxicological centre.

METHODS

The data were systematically collected on PubMed, Scopus and SciELO databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We included epidemiologic and prevalence studies that were published in English or Portuguese from 2013 to 2017 and covered paediatric patients. The retrospective incidence study was carried out in a Brazilian toxicological centre and was a documentary analysis of paediatric medication poisoning cases from 2005 to 2015.

RESULTS

The systematic review comprised 13 papers covering 895 206 poisoning cases from six different countries. The main agents of intoxication were analgesics and antihistamines. The eight papers that explored the reasons for the poisonings showed that 93% of those 762 863 cases were accidental. The Brazilian toxicological centre recorded 443 paediatric patients poisoned by medication such as benzodiazepines, analgesics and antibiotics and found that 63.2% were accidental. However, it agreed with the global findings in many other aspects.

CONCLUSION

The systematic review showed a sustained number of paediatric medication toxicity cases worldwide and the key findings were broadly reflected by the retrospective study carried out in the Brazilian toxicological centre.

Pattern of food, drug and chemical poisoning in Qassim region, Saudi Arabia from January 2017 to December 2017

Background

Poisoning has become a widespread and dangerous phenomenon worldwide. The purpose of our study was to determine and analyze the pattern of poisoning cases induced with food, drugs, and chemicals reported to the Department of Environmental and Occupational Health in Qassim province in the Kingdom of Saudi Arabia. The study also evaluated the correlation of demographic variables such as age, type of toxicity and geographical distribution associated with poisoning in Qassim province.

Methods

This retrospective cross-sectional study was performed on 381 cases of poisoning. The data was collected from Jan 2017 to Dec 2017 and revealed that out of 381 cases, 120 have food poisoning (65 % females and 35 % males), 180 have drug poisoning (55.56 % females and 44.44 % males), whereas 81 cases have chemical poisoning (41.98 % female and 58.02 % male). Data were statistically analyzed using SPSS/PC statistical package. The study revealed that the most common agents involved in acute poisoning were drugs (47.25 %), especially analgesics such as Paracetamol (Acetaminophen), followed by antipsychotic drugs. Food poisoning was the second acute poisoning with (31.40 %). Finally, chemical poisoning involved in acute poisoning with 21.20 % of cases reported household products accomplished strongest bleach (chlorines)(Clorox®) and insecticides were the secondary source for chemical poisoning.

Poisoning due to household products: A ten years retrospective analysis of telephone calls to the National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi, India

Extensive use of different chemicals in various fields and their easy availability has led to an increased incidence of accidental and intentional poisoning in developing countries including India. A diverse range of household products commonly used for domestic purposes comprise pesticides, household cleaners, thermometer mercury, antiseptics, kerosene, paint thinners etc. Any of these products, if misused or mishandled can cause poisoning. In India, the National Poisons Centre (NPIC) at the All India Institute of Medical Sciences, New Delhi, provides information on management of poisoning to treating physicians. Analysis of data based on telephone calls received by the NPIC (April 2006-March 2016) has highlighted a high incidence of poisoning due to household products, followed by pharmaceuticals, agricultural pesticides and industrial chemicals. The objective of the present retrospective study was to determine the incidence of poisoning due to various household products as reported to the NPIC during the ten years period. The total number of calls received by the Centre was 16,420. There were 7114 calls (45.5%) due to household products with adults (>18yrs.) and children (<1-18yrs.) constituting 38.7% and 61.2% calls respectively. Males outnumbered females (M = 62.4%, F = 37.5%). The mode of poisoning was mainly unintentional (66.8%) followed by intentional mode (33.2%). The commonest route of exposure was oral (95.6%). Household pesticides were commonly implicated (43.7%) followed by household cleaners (21.8%), thermometer mercury (5.2%) naphthalene balls (5%), antiseptics (3%), kerosene (2%) and paint thinner (2%). Miscellaneous products comprising of camphor, silica gel, hair dye, nail polish remover, cosmetics, adhesives etc were also involved in poisoning (17.1%). The trend and pattern of poisoning varies in different parts of the country, because all calls on poisoning are not reported to the Centre. So the data as such may not be a true reflection of the scenario in India. However, the results do indicate an increasing incidence of poisoning due to household products especially in children. The probable reasons for high incidence could be careless storage, ignorance, non compliance with prescribed instructions for use and negligible parental supervision in case of children. The results of the study highlight, an urgent need to identify high risk circumstances, common toxic products involved and implementation of prevention and awareness programmes, to achieve poisons control at home.

[Clinical features of acute poisoning in hospitalized children: an analysis of 586 cases]

OBJECTIVE

To investigate the clinical features of acute poisoning in hospitalized children.

METHODS

A retrospective analysis was performed on the clinical data of 586 hospitalized children who were diagnosed with poisoning and discharged from the Children's Hospital of Chongqing Medical University between January 2006 and December 2015.

RESULTS

The patients included 354 males and 232 females (age: 24 days to 15.8 years). Of the 586 cases, 450 (76.8%) were infants and preschool children; 463 (79.0%) came from rural areas; 551 (94.0%) were hospitalized because of unintentional poisoning. The drug poisoning, pesticide poisoning, and rodenticide poisoning accounted for 221 cases (37.7%), 167 cases (28.5%), and 175 cases (29.9%) respectively. There was a significant difference in the distribution of the poisoning toxins between urban and rural children (P<0.01), and drugs and pesticides were the most common toxins for urban and rural children respectively. There were significant differences in main clinical manifestations between the children with drug poisoning, pesticide poisoning, and rodenticide poisoning (P<0.01), who presented with main clinical symptoms of the nervous system, digestive system, and circulatory system respectively. There was no significant difference in overall response rate between the children poisoned by different toxins.

CONCLUSIONS

Acute poisoning is most common in infants and preschool children. The majority of the patients are from rural areas. The majority of acute poisoning is unintentional. Poisoning by drugs is the main type of acute poisoning. There is no significant difference in overall response rate between the children poisoned by different toxins, but their clinical manifestations are different.