Trends in paediatric poisoning in the North-Central Province of Sri Lanka

Abstract

Introduction and Objectives: Evidence of paediatric poisoning, which is preventable, has been lacking in North-Central province (NCP) of Sri Lanka. This study identifies the trends in paediatric poisoning in NCP including the risk factors, complications, and the outcome of acute poisoning. Methods: All children with acute, accidental or deliberate poisoning admitted to paediatric wards at Anuradhapura and Polonnaruwa teaching hospitals were included in the study. They were assessed using clinical interviews, focus group discussions, clinical observations and bed head ticket based records over a period of eight months from March 2012. Results: Among 167 children 53% were male and 91% were below six years. The majority of parents were agricultural workers (25%) and 51% had received education upto ordinary level. Accidental poisoning was predominantly observed (97%) and the commonest poison was kerosene oil (24.9%). Reasons for delayed medical care included lack of transport (14%) and knowledge (12%), lack of concern regarding urgency (12%) and financial problems (8%). Complications included acute liver injury (4.2%), chemical pneumonitis (3.6%), and convulsions (1.8%) with zero mortality. Risk factor analysis revealed inadequate supervision by parents (87.5%) as the commonest risk factor. Poor storage of household chemicals (52%) and medicines (40%) were more common compared to other risk factors. Conclusions: Children become victims of acute poisoning mostly due to inadequate supervision by their parents and unsafe storage of poisons. Because of poor storage of medicines, household chemicals are increasingly associated with accidental poisoning. Therefore, community education and safe storage will reduce the incidence of paediatric poisoning.