Childhood poisoning: a 10-year experience in a tertiary hospital in Enugu State, Nigeria

Submitted: 3 February 2024
Accepted: 16 May 2024
Published: 12 June 2024
Abstract Views: 247
PDF: 293
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Childhood Poisoning is a common cause of emergency room presentation, more so in underdeveloped countries where it contributes to a high incidence of hospitalization with variability in morbidity and mortality. This study retrospectively assessed the sociodemographic profiles, poisoning agents, clinical features and management of cases of childhood poisoning admitted at Enugu State University Teaching Hospital, Enugu. It was a 10-year retrospective study of all the cases of childhood poisoning admitted within the period of study at the Children’s Emergency Room of Enugu State University Teaching Hospital (ESUTH), Enugu. The prevalence of childhood poisoning in the study was 0.3%. Of all the subjects, 78.4% were ≤5 years and more than half were males and from lower socioeconomic classes. Accidental poisoning accounted for 70.3%; the predominant agents were kerosene and organophosphates. Palm oil was used by 67.6% of the participants as an intervention before presentation. Pneumonitis was the most common complication. Patients with peripheral oxygen saturation (SpO2) < 95% were 14 times more likely to have complications than those with SpO2 ≥ 95%. The duration of hospital stay was ≤3 in 59% of the cases and no mortality was recorded in this study.Childhood poisoning remains prevalent in our environment with kerosene being the commonest agent. Palm oil administration as a predominant pre-hospital intervention worsens outcomes. Duration of hospitalization depends on SpO2 at presentation, need for antibiotic therapy, and intention. 

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Citations

Poisoning: First aid - Mayo Clinic. Accessed 2023 Jan 11. Available from: https://www.mayoclinic.org/first-aid/first-aid-poisoning/basics/art-20056657
Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iranian J Pediatr 2011;21:479.
Oguche S, Bukbuk DN, Watila IM. Pattern of hospital admissions of children with poisoning in the Sudano-Sahelian North eastern Nigeria. Nigerian J Clinical Pract 2007;10:111–5.
Ahmed PA, Nwatah VE, Ulonnam CC. Childhood accidental poisoning among hospitalised children in a tertiary health care in North Central Nigeria - A two year prospective report. Nigerian J Paediatr 2020;47(3). DOI: https://doi.org/10.4314/njp.v47i3.5
Woyessa AH, Palanichamy T. Patterns, Associated factors, and clinical outcomes of poisoning among poisoning cases presented to selected hospitals in western Ethiopia: hospital-based study. Emerg Med Internat 2020;2020:1–9. DOI: https://doi.org/10.1155/2020/5741692
Koirala DP, Rao KS, Malla KK, Malla T. A study of clinical features, management and outcome of organophosphate and carbamate poisoning in children. J Nepal Paediatr Soc 2013;33:85–90. DOI: https://doi.org/10.3126/jnps.v33i2.7799
Lee J, Fan NC, Yao TC, et al. Clinical spectrum of acute poisoning in children admitted to the pediatric emergency department. Pediatr Neonatol 2019;60:59–67. DOI: https://doi.org/10.1016/j.pedneo.2018.04.001
Oba-Daini OU, Ogunlesi TA, Adekanmbi AF, and Akodu SO. Childhood poisoning in Sagamu, Southwest, Nigeria. Niger J Paediatr 2020;47:1–5.
Belonwu RO, Adeleke SI. A seven-year review of accidental kerosene poisoning in children at Aminu Kano Teaching Hospital, Kano. Nigerian J Med 2008;17:380–2. DOI: https://doi.org/10.4314/njm.v17i4.37415
Martin TC, Brinkman W. The spectrum of accidental childhood poisoning in the Caribbean. Revista Panamericana de Salud Pública 2002;12:313–6. DOI: https://doi.org/10.1590/S1020-49892002001100004
Gauvin F, Bailey B, Bratton SL. Hospitalizations for pediatric intoxication in Washington State, 1987-1997. Arch Pediatr Adolesc Med 2001;155:1105-10. DOI: https://doi.org/10.1001/archpedi.155.10.1105
Mintegi S, Azkunaga B, Prego J, et al. International epidemiological differences in acute poisonings in pediatric emergency departments. Pediatr Emerg Care 2019;35:50–7. DOI: https://doi.org/10.1097/PEC.0000000000001031
Olatunya OS, Isinkaye AO, Ogundare EO, et al. Childhood poisoning at a tertiary hospital in South West Nigeria. J Nepal Paediatr Soc 2015;35:103–10. DOI: https://doi.org/10.3126/jnps.v35i2.12548
Ndu IK, Uleanya ND, Nwokoye IC, et al. Pattern of morbidity and mortality at the children emergency unit of Enugu State Teaching Hospital, Park Lane, Enugu. J Exp Res 2016;4:48-54.
Orisakwe OE, Egenti L, Orish C. Childhood non-drug poisoning in Nnewi, Nigeria. Tropical Doctor 2000;30:209–11. DOI: https://doi.org/10.1177/004947550003000409
Ogunlesi A, Dedeke I, Kuponiyi O. Socio-economic classification of children attending specialist paediatric centres in Ogun State, Nigeria. Niger Med Pract 2008;54:21–5. DOI: https://doi.org/10.4314/nmp.v54i1.28943
Edelu BO, Odetunde OI, Eke CB, et al. Accidental childhood poisoning in Enugu, South East, Nigeria. Ann Med Health Sci Res 2016;6:168-71. DOI: https://doi.org/10.4103/2141-9248.183944
National Agency for Food and Drug Administration and Control (NAFDAC). Press Release On The Regulation And Control Of Pesticides In Nigeria. Accessed 2023 Nov 23. Available: https://www.nafdac.gov.ng/press-release-on-the-regulation-and-control-of-pesticides-in-nigeria/#:~:text=In%202020%2C%20the%20Agency%20in,public%20health%2C%20and%20bearing%20in
Jose A, Sivanandam S, Matthai J. Poisoning in children from an educationally and economically advanced urban area of south India. Asian J Epidemiol 2012;5:123. DOI: https://doi.org/10.3923/aje.2012.123.129
Eze JN, Ndu IK, Edelu BO. Teenage organophosphate insecticide poisoning: An ugly trend in Enugu, Nigeria. J Comm Med Primary Health Care 2018;30:99-108.
Calello DP, Henretig FM. Pediatric toxicology: specialized approach to the poisoned child. Emerg Med Clinics 2014;32:29-52. DOI: https://doi.org/10.1016/j.emc.2013.09.008
Oreh AC, Uchemefuna I, Mmamelu N, et al. Accidental kerosene oil ingestion in under-five age children in Nigeria–The need for vigilance in primary care settings in low-and middle-income countries (LMICs). J Fam Med Primary Care 2023;12:796. DOI: https://doi.org/10.4103/jfmpc.jfmpc_1840_22
Reda GB, Abate HK, Mekonnen HM, et al. Outcome of poisoning and associated factors among patients admitted at referral hospitals in northwest Ethiopia, 2022: multicenter retrospective study. Open Access Emerg Med 2023;2023:415-25. DOI: https://doi.org/10.2147/OAEM.S414743
Lin YR, Liu TH, Liu TA, et al. Pharmaceutical poisoning exposure and outcome analysis in children admitted to the pediatric emergency department. Pediatr Neonatol 2011;52:11-7. DOI: https://doi.org/10.1016/j.pedneo.2010.12.003
Das S, Behera SK, Xavier AS, Selvarajan S. Prophylactic use of steroids and antibiotics in acute hydrocarbon poisoning in children. J Pharmacy Pract 2020;33:90-5.
Venkatesh C, Sriram P, Adhisivam B, Mahadevan S. Clinical profile of children with kerosene aspiration. Tropical Doctor 2011;41:179-80 DOI: https://doi.org/10.1258/td.2011.110093
Kumar S, Kavitha TK, Angurana SK. Kerosene, camphor, and naphthalene poisoning in children. Indian J Crit Care Med 2019;23:S278. DOI: https://doi.org/10.5005/jp-journals-10071-23316
Das S, Behera SK, Xavier AS, Selvarajan S. Prophylactic use of steroids and antibiotics in acute hydrocarbon poisoning in children. J Pharm Pract 2020;33:90-5. DOI: https://doi.org/10.1177/0897190018771520
Yasui H, Yokomura K, Suda T. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid. Respirat Med Case Rep 2016;17:64-7. DOI: https://doi.org/10.1016/j.rmcr.2016.01.009
Graham JR. Pneumonitis following aspiration of crude oil and its treatment by steroid hormones. Transact Am Clin Climatol Assoc 1956;67:104.
Peden M, Oyegbite K, Ozanne-Smith J, et al., editors. World Report on Child Injury Prevention. Geneva: World Health Organization; 2008. 6, Poisoning. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310644/

How to Cite

Iheji, C. C., Onu, N. N., Nduagubam, O. C., Usuah, J. A., Iheji, G. U., & Ndu, I. K. (2024). Childhood poisoning: a 10-year experience in a tertiary hospital in Enugu State, Nigeria. Emergency Care Journal, 20(2). https://doi.org/10.4081/ecj.2024.12351