Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda

Abstract

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.

Acute pesticide poisoning amongst adolescent girls and women in northern Tanzania

“…Again, this may be a function of under-reporting resulting from the absence of a comprehensive surveillance system for APP in Tanzania as well as misdiagnosis of signs and symptoms of pesticides exposure. Previous research suggests that occupational cases may be missed [1] since farmers do not present to hospitals, especially for less severe poisonings, but rather wait to recover or use alternative treatments [10].…”

“…This study was based on surveillance implemented at 10 health facilities in three regions of Tanzania (Mwanza, Kilimanjaro and Arusha) for APP admissions over a 12month period from January 1st to December 31st 2006. These are regions where intensive vegetable and/or coffee production was associated with intensive pesticide use [10]. The 10 hospitals included regional hospitals, district hospitals, health centers and dispensaries.…”

“…Medical data recorders were trained to use standardised methods to extract data on APP from facility records (both registers and patient folder) with regards to date of poisoning, location, gender, circumstances of poisoning and outcome. This paper focuses on the findings involving adolescent and adult females [10].…”

“…Acute pesticide poisoning (APP) is documented as a serious public health problem in Tanzania [1,2] and other parts of the world [3][4][5][6][7][8][9] due to its adverse human health effects. Evidence of APP occurring in women is documented in studies from Tanzania [2,10], Uganda [11], Kenya [12], South Africa [13,14], India [15], China [16], Nepal [17], Sri Lanka [18], Iran [19] and Ethiopia [20]. A 2002 review of APP globally suggested that pesticiderelated morbidity and mortality is under-reported amongst women [21].…”

“…Poisoning is reported in the health management information system within Tanzanian hospitals with non-standardised information on the causative agent. Previous studies have reported the lack of specificity of reporting of pesticide poisoning in hospital information systems [10].…”