BACKGROUND: Unintentional poisoning is implicated in about 2% of all injury-related deaths among children from developing counties. Poisoning ranked 2nd among commonest injury and 3rd most common pediatric ED visits. National health survey of Pakistan estimated 4.3% unintentional poising among children <5 years of age. Most studies focus on types of poisoning; only a few highlighted the factors associated with ingestion. Few epidemiological studies from Pakistan and the region around identified few factors associated with poisoning among children like overcrowding, maternal education, socioeconomic of the family, family type (nuclear or joint), number of siblings etc. We try to document few additional factors behind common pediatric household unintentional poisoning from the largest tertiary care teaching hospital like frequency, outcome and socio-demographic factors especially focusing on maternal education, mother on the job when the child had exposure to poison and timing of ingestion.
METHODS: This was a descriptive case series study conducted at the ED of the National Institute of Child Health (NICH), Karachi during 2017-2018. Data collection was non-probability consecutive sampling on a predesigned, tested and approved questionnaire. The sample size was 253. All children aged 12 or below of either gender, who presented with a clear history of unintentional ingestion of poison were included. Frequency and percentage were presented for the type of poisoning, absence of parent/primary caregiver, maternal education status, maternal age, maternal job, family type, family income and outcome of poisoning
RESULTS: Out of 253 observed cases 132 (52%) were male and most were <5 years of age with mean ± SD of age 4.41±3.31 (CI of 4.00-4.81) years. Around 200 (79.05%) children were exposed either during the afternoon or by early evening and mother or caregiver was not present around the child in 173 (68%) cases while the child exposed to poison. In 150 (59%) children mother age was over 30 years and 200 (79%) mothers either had tenth grade or minimal educational experience. A joint family system was present in 213 (84 %) children with more than five adult member living together mostly in a small house. The number of children (>3) living together was found in 101 (40%) cases of poisoning of which 83 (82%) were when mother was on job. The poor family class was found in 125 (49%) children, though a majority of these mothers use to do some jobs 205 (81%) either at the home or outside. Commonly ingested poisons were drugs (33.78%) and hydrocarbon (32.80%) followed by organophosphorus (16.60%) exposure. Forty-two (16.60%) children were discharged, 48(18.97%) went LAMA, 11(4.34%) expired and 152 (60.09%) admitted.
CONCLUSION: During this study it was found that certain socio-demographic factors like low parental education and socioeconomic status, larger family size or children in family, unsafe storage of medicines and household chemicals have significant effect on childhood poisoning and by addressing them we can decrease unintentional poisoning cases in children. Kerosene ingestion and easily available drugs remain the most common ingestions.
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No competing interests reported.
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Posted 16 Mar, 2021
Posted 16 Mar, 2021
BACKGROUND: Unintentional poisoning is implicated in about 2% of all injury-related deaths among children from developing counties. Poisoning ranked 2nd among commonest injury and 3rd most common pediatric ED visits. National health survey of Pakistan estimated 4.3% unintentional poising among children <5 years of age. Most studies focus on types of poisoning; only a few highlighted the factors associated with ingestion. Few epidemiological studies from Pakistan and the region around identified few factors associated with poisoning among children like overcrowding, maternal education, socioeconomic of the family, family type (nuclear or joint), number of siblings etc. We try to document few additional factors behind common pediatric household unintentional poisoning from the largest tertiary care teaching hospital like frequency, outcome and socio-demographic factors especially focusing on maternal education, mother on the job when the child had exposure to poison and timing of ingestion.
METHODS: This was a descriptive case series study conducted at the ED of the National Institute of Child Health (NICH), Karachi during 2017-2018. Data collection was non-probability consecutive sampling on a predesigned, tested and approved questionnaire. The sample size was 253. All children aged 12 or below of either gender, who presented with a clear history of unintentional ingestion of poison were included. Frequency and percentage were presented for the type of poisoning, absence of parent/primary caregiver, maternal education status, maternal age, maternal job, family type, family income and outcome of poisoning
RESULTS: Out of 253 observed cases 132 (52%) were male and most were <5 years of age with mean ± SD of age 4.41±3.31 (CI of 4.00-4.81) years. Around 200 (79.05%) children were exposed either during the afternoon or by early evening and mother or caregiver was not present around the child in 173 (68%) cases while the child exposed to poison. In 150 (59%) children mother age was over 30 years and 200 (79%) mothers either had tenth grade or minimal educational experience. A joint family system was present in 213 (84 %) children with more than five adult member living together mostly in a small house. The number of children (>3) living together was found in 101 (40%) cases of poisoning of which 83 (82%) were when mother was on job. The poor family class was found in 125 (49%) children, though a majority of these mothers use to do some jobs 205 (81%) either at the home or outside. Commonly ingested poisons were drugs (33.78%) and hydrocarbon (32.80%) followed by organophosphorus (16.60%) exposure. Forty-two (16.60%) children were discharged, 48(18.97%) went LAMA, 11(4.34%) expired and 152 (60.09%) admitted.
CONCLUSION: During this study it was found that certain socio-demographic factors like low parental education and socioeconomic status, larger family size or children in family, unsafe storage of medicines and household chemicals have significant effect on childhood poisoning and by addressing them we can decrease unintentional poisoning cases in children. Kerosene ingestion and easily available drugs remain the most common ingestions.
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