Prevalence and clinical management of common poisoning in pediatric patients seen at the University Teaching Hospital in Lusaka

Abstract

Acute poisoning is one of the most common causes of increase in morbidity and mortality rate worldwide with 0.3 million people dying every year. It is a major problem in the paediatric population causing 45000 deaths in children and youths under 20 years of age. Mortality in children less than 10 years represent up to 80% of all victims of poisoning. In Zambia information on poisoning is meagre. The aim of the study was to determine the prevalence, different poisoning types, management and outcome of common poisoning among pediatric patients seen at the main referral hospital in Zambia in order to provide information on evolving trends of poisoning. A hospital-based cross-sectional study was carried out on all cases of acute poisoning who fitted into the study eligibility criteria admitted to 3 units at the Department of Paediatrics and Child Health of the University Teaching Hospital (UTH) in Lusaka, Zambia from January to May 2015. The 3 units included Emergency Unit, Intensive Care Unit and Admissions ward. Demographic data, data on poisoning, management and outcomes as well as information from the caregiver were collected using a data collection form. Data was then analysed using SPSS version 16. Acute poisoning constituted 1.0% of the total hospital admissions at the paediatric department. Organophosphates, drugs as well as wild seeds were the most implicated agents accounting for 21%, 21% and 19.7% respectively. Plant poisons and kerosene contributed significantly to the number of cases. It was found that 60% of patients were not managed according to Standard Treatment Guidelines (STG’s), 34.3% employed resuscitation measures or made an attempt to remove the poison and 71% attempted resuscitation plus made an attempt to remove the poison. No deaths were recorded. The prevalence of acute poisoning in children aged 15 and below is relatively low at the University Teaching Hospital in Lusaka, Zambia. Acute poisoning affected more male children and resulted in admission mainly due to organophosphates, drugs and wild seeds. There is poor adherence to standard treatment guidelines but the clinical outcome remains very good.