Need for an acute poisoning registry data base in India

Abstract

Acute poisoning is one of the common reasons for hospitalisation in developing countries. 1 In countries like India, where the economy is linked substantially to agriculture, the number of cases of acute poisoning increase every year. While in developed countries, the rate of mortality from poisoning ranges from 1% to 2% in developing countries like India, it varies between 15% and 30% and is the fourth most common cause of mortality, especially in rural India. 2 The rapid increase in the use of newer chemicals with potentially harmful effects is a matter of concern to the physician and makes the management more challenging. 3 The monsoon-dependent agricultural practice and socioeconomic factors related to it also play a role in the incidence of acute poisonings. 4 Insufficient regulation for the sale and use of pesticides, lack of surveillance systems, insufficient enforcement regarding safe use of pesticides, lack of training of healthcare professionals regarding the management aspects, inadequate access to information system, and poorly maintained or non-existent personal protective equipment are the major factors responsible for higher incidence rate of poisoning. 5 Early diagnosis, treatment and prevention are crucial in reducing the burden of poisoning-related injury in any country. 6 A thorough knowledge about the nature and magnitude of the problem in a particular area is essential for the doctors in hospital practice.In India the exact incidence of acute poisoning cannot be defined properly due to under-reporting of cases to Government authorities. India has an over-usage of pesticides, and in particular organophosphate poisoning is most commonly reported in the emergency departments of Indian hospitals. 7 The data from poison information centre of All India Institute of Medical Sciences (AIIMS) reveals that highest incidence of poisoning cases was found in the age group of 14-40 years, with a preponderance of males affected. 8 According to the World Health Organization (WHO), 99% of the fatal poisoning cases occur in developing countries, predominantly among farmers. 4,9,10 Implementing a poisoning registry database in hospitals will enhance the quality of clinical management by allowing access to information about all poisoning cases previously treated there. This approach would also help to disseminate information about newer antidotes or treatment modalities in the management of poisoning.There is a growing need for such a database to be developed and implemented in the hospital setting. The information would not only provide the information regarding signs and symptoms of poisoning, but will also help in identifying the risk factors and newer management options. Finally, it is expected that this type of approach will also help in identifying the areas and communities that are prone to frequent poisoning cases. This will help in developing educational guidelines for the different sectors regarding the harmful effects of poison.

Developing the minimum data set of the corrosive ingestion registry system in Iran

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The Features and Processes of Poisoning Registries: A Scoping Review

“…Poison information systems and registries play an essential role in the prevention, treatment, and patient follow-up in developed countries. Thus, it is an emerging tool in healthcare data management and support in developing countries [29].…”

Data Requirements for Information Management System Development for Poisoning with Acidic and Alkaline Substances

“…The prevalence of esophagus burn caused by caustic substances is 15.8% in 1000 cases (8). Lack of monitoring system, inadequate education of health care professionals regarding the management of such poisonings and lack of access to the proper information system might be the major reasons for the high prevalence of this poisoning (9). In the age of information technology, the use of information systems may improve make decisions.…”