Clinical profile and outcome of children presenting with poisoning or intoxication: a hospital-based study

Authors

  • Mahvish Qazi Department of Gynaecology and Obstetrics ASCOMS, Sidhra, Jammu, Jammu and Kashmir, India
  • Najmus Saqib Department of Paediatrics, GMC Jammu, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20183518

Keywords:

Children, Clinical profile, Poisoning

Abstract

Background: Poisoning is a common preventable cause of morbidity and mortality in children. Most of the poisoning in children less than 5 years of age is accidental. Not much of Indian data is available particularly from this part of the country. So, authors conducted a retrospective hospital record-based study to know clinical profile and outcome of children presenting with poisoning in our set up. The objective was to study clinical profile, outcome of childhood poisoning and intoxication in Jammu District (Jammu and Kashmir) India

Methods: This was a retrospective hospital record-based study done in patients who were admitted in pediatric wards and pediatric intensive care unit (PICU) of SMGS Hospital Jammu with history of ingestion of poison or intoxication or envenomation from January 2017 to December 2017. The data collected was analyzed with SPSS 12.0 software. Demographic and etiological factors were retrospectively recorded and analyzed.

Results: There were 227 children enrolled in study with an incidence of 0.99%. Male: female ratio was 1.2:1. Most of the children were asymptomatic and majority of them arrived to the hospital in less than 2 h. The majority of our patients 115 (50.66%) were in the 13-18 years age group. Organophosphorus poisoning was the commonest poisoning seen in 51 (57.30%) patients followed by snake bite 29 (55.77%), insect bite 17 (32.69%), Phenol 14 (77.78%), kerosene 11 (12.36%) and rat poison 10 (11.23%). Alcohol problem occurred in 9 (24.32%) cases. The most frequent cause of suicide attempt were school problems, followed by conflict in the family. Route of poisoning was ingestion in 173 (76.21%) cases followed by bites 53 (23.35%) and inhalation in 1 (0.44%) case. Vomiting 105 (46.25%) was the predominant clinical feature. Aspiration pneumonia 17 (43.59%) followed by respiratory failure 7 (17.95%) were the most common complications. During treatment 67 (27.91%) received gastric lavage and 28 (12.33%) received antidotes. Overall survival was 210 (92.51%), among remaining cases 2 (0.88%) cases died in hospital and 15 (6.61%) cases left against medical advice

Conclusions: Parental health education will decrease the occurrence of childhood poisoning. Along with the parents and teachers, media also should take active steps to educate the rural population about the preventive measures from bite, stings and handling of poisonous agents. 

References

Singh M, Hessam MY, Azamy S, Arya LS. Spectrum of poisonings among children in Afghanistan. Indian J Pediatr. 1984;51(3):313-6.

Steele P, Spyker DA. Poisonings. Pediatr Clin North Am. 1985;32(1):77-85.

Rodgers GC Jr, Condurache T, Reed MD, Bestic M, Gal P. Poisonings. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF. Nelson’s Textbook of Pediatrics. New York: Saunders: Elsevier; 2007:689-732.

Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Giffin SL. Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (Phila). 2009;47(2):911-1084.

Pesticides and health in the Americas [Environment Series No. 12]. Washington: World Health Organization; 1993.

Abula T, Wondmikun Y. The pattern of acute poisoning in a teaching hospital, north-west Ethiopia. Eth Med J. 2006;44(2):183-9.

Suvedi BK. A retrospective study of poisoning cases at Bir Hospital, Nepal. J Inst Med. 1990;12:296-302.

GR Lawson, AW Craft and RH Jackson Changing Pattern of poisoning in children in Newcastle, 1974-81. BMJ 1983;287:15-17.

Brata Ghosh V, Jhamb U, Singhal R, Krishnan R. Common childhood poisonings and their outcome in a tertiary care center in Delhi. Indian J Pediatr. 2013;80(6):516-8.

Roy RN, Shrivastava P, Das DK, Saha I, Sarkar AP. Burden of hospitalized pediatric morbidity and utilization of beds in a tertiary care hospital of kolkata, India. Indian J Community Med. 2012;37(4):252-5.

Jayashree M, Singhi S. Changing trends and predictors of outcome in patients with acute poisoning admitted to the intensive care. J Trop Pediatr. 2011;57(5):340-6.

Kohli U, Kuttiat VS, Lodha R, Kabra SK. Profile of childhood poisoning at a tertiary care centre in North India. Indian J Pediatr. 2008;75(8):791-4.

Singh S, Sood NK, Walia BNS, Kumar L. Changing pattern of childhood poisoning: Experience of a large north Indian Hospital. Indian Pediatr. 1995;32:331

Singhal PK, Kumar H, Rastogi V, Saili A, Patwari AK, Mullick DN. Accidental poisoning. Indian Pediatr. 1988;25:350-3.

Niayaz AB, Ahmed K, Sethi AS. Poisoning in children. Indian Pediatr.1991;28:521-4.

Dutta AK, Seth A, Goyal PK, Aggarwal V, Mittal SK, Sharma R et al. Poisoning in children: Indian scenario. Indian J Pediatr. 1998;65(3):365-70.

Sreeramareddy CT, Sathyanarayana TN, Kumar HN. Utilization of health care services for childhood morbidity and associated factors in India: a national cross-sectional household survey. PLoS One. 2012;7(12):e51904.

Singhi S, Gupta G. Comparison of pediatric emergency patients in a tertiary care hospital vs a community hospital. Indian Pediatr. 2004;41(1):67-72.

Aqeel M, Munir A, Khan A. Pattern and frequency of acute poisoning in children. Pak J Med Sci. 2009;25(3):479-83.

Patel V, Ramasundarahettige C, Vijayakumar L, Thakur JS, Gajalakshmi V, Gururaj G, et al. Suicide mortality in India: a nationally representative survey. Lancet. 2012;379(9834):2343-51.

Fliege H, Lee JR, Grimm A, Klapp BF. Risk factors and correlates of deliberate self-harm behavior: a systematic review. J Psychosom Res. 2009;66(6):477-93.

Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self-harm in adolescents: self-report survey in schools in England. BMJ. 2002;325(7374):1207-11.

Gupta SK, Peshin SS, Srivastava A, Kaleekal T. A study of childhood poisoning at National Poisons Information Centre, All India Institute of Medical Sciences, New Delhi. J Occup Health. 2003;45(3):191-6.

Ramesh S, Srikanth S, Parvathy VR. Poisoning in children. Indian J Pediatr. 1986;54:769-73.

Opawoye AD, Haque T. Insecticide/organophosphorus compound poisoning in Children. Ann Saudi Med. 1998;18:171-2.

O’connor PJ. Differentials in poisoning rates of young Australian children according to residential location and geographical remoteness. Inj Prev. 2005;11:204-6.

Pathak UN, Chhetri PK, Dhungel S, Chokhani R, Devkota KC, Shrestha BO. A retrospective study of poisoning cases admitted in Nepal Medical College Teaching Hospital. Nepal Med Coll J. 2001;3:101-5.

Lifshitz M, Gavrilov V. Acute poisoning in children. Isr Med Assoc J. 2000;2(7):504-6.

Petridou E, Polychrionopoulou A, Kouri N, Karpathios T, Koussouri M, Messaritakis Y. Unintentional childhood poisoning in athens: a mirror of consumerism? J Toxicol Clin Toxicol.1997;35(6):669-75.

Rajka T, Heyerdahl F,Hovda KE, Stiksrud B, Jacobsen D. Acute child poisonings in Oslo: a 2-year prospective study. Acta Pediatr. 2007;96(9):1355-9.

Rathore S, Verma AK, Pandey A, Kumar S. Pediatric poisoning trend in Lucknow district, India. J Forensic Res. 2013;4(1):179-80.

Ram P, Kanchan T, Unnikrishnan B. Pattern of acute poisonings in children below 15 years: a study from Mangalore, South India. J Forensic Leg Med. 2014;25:26-9.

Fernando R. Management of pesticide poisoning. Poisoning in Sri Lanka Ceylon Medical J. 1988;33:39-41.

Klein BL. Hydrocarbon poisonings. Paediatr Clin North Am. 1986;33(2):411-9.

Scherz RG, Latham GH, Stracener CE. Child resistant containers can prevent poisoning. Pediatr. 1969;43(1):84.

Lucas GN. A hospital based prospective study of acute childhood poisoning. Sri Lanka J Child Health. 2008;35(1):12-9.

Esmaeili MD, Bayati Z, Gholitabar ZM. A report of childhood poisoning in Babol. Arch Iranian Med. 2004;7(4):297-9.

Kumar A, Verma A, Kumar A. Accidental human poisoning with a neonicotinoid insecticide, imidacloprid: a rare case report from rural India with a brief review of literature. Egypt J Forensic Sci. 2013;3(4):123-6.

Gupta P, Singh RP, Murali MV, Bhargava SK, Sharma P. Kerosene oil poisoning: a childhood menace. Indian Pediatr. 1992;29:978-84.

Ellis JB, Krug A, Roberston J, Hay IT, MacIntyre U. Paraffin ingestion-the problem. S Afr Med J. 1994;84(11):727-30.

Downloads

Published

2018-08-24

Issue

Section

Original Research Articles