Poisoning in children: Indian scenario

Abstract

The retrospective data on childhood poisoning from eight regional hospitals in India has been reviewed. The demographic features and types of poisonings encountered have been compared. The analysis of the data indicated that pediatric poisonings constituted 0.23-3.3% of the total poisoning. The mortality ranged from 0.64-11.6% with highest being from Shimla. Accidental poisoning was common involving 50-90% of children below 5 years of age and males outnumbered the females. Suicidal poisoning was seen after 13 years of age and was due to drugs and household chemicals. One of the hospitals in Delhi recorded a very high incidence (66.6%) of drug poisoning in children. The drugs consumed belonged to phenothiazines, antiepileptics and antipyretics. Iron poisoning was seen in younger children. Kerosene was one of the causes of accidental poisoning at all hospitals except Shimla and rural Maharashtra were probably wood charcoal is widely used. Pesticide poisoning was more prevalent in Punjab and West Bengal whereas plant poisoning was very common in Shimla. Significant number of snake envenomation has been recorded from rural Maharashtra. Other less common accidental poisonings in children included alcohol, corrosives, heavy metals, rodenticides, detergents and disinfectants. Thus various regions in the country showed some variation in types and frequency of childhood poisoning which could be attributed to different geographical and socio-economic background.

A prospective study of paediatric autopsies conducted at Bapuji Hospital and Research Centre, Davangere.

“…Our study results in consistent with an Indian study; accidental poisoning was common in children below 5 years of age whereas suicidal poisoning was more after 13 years of age 18 . Accidental poisoning predominated in another study done in Boston 19 .…”

Incidence Prevalence Clinical Overview and Cost Analysis of Pediatric Poisoning Cases in a Tertiary Care Setting of Berhampur, Odisha, India.

“…This is supported by a study done by Dutta AK et al [14] where suicidal poisoning cases are more commonly seen in patient elder than 13 year age group.…”

A study on profile of poisoning in pediatric population

“…[23][24][25] With respect to sex preponderance, incidence was more common in males in less than 5 years of age group, whereas female predominance was seen in adolescent age group; with overall female predominance, while other studies showed overall incidence to be more common in males. 8,15,17,[23][24][25][26][27] Majority of the children are aged above 10 years (60.5%) followed by less than 5 years (34.2%). Similar results are observed in study done by Sharma et al 25 Other studies reported the most common age group being 1-6 years.…”

“…Poisoning in older children and adolescents is more often intentional, especially due to increasing stress. 15,16 The most common cause of acute medical illness in many countries has been exposure to toxic substances. 9,[17][18][19][20] General epidemiological data should be used to assist emergency department on proper management of poisoning cases especially for effective preventive and therapeutic approaches.…”