Epidemiology of childhood poisoning in Kelantan

Abstract

Accidental poisoning in children is a common problem world-wide and continues to be one of the major causes of mortality and morbidity in young children. This study describes the characteristic of children admitted for ingested poison, the types of poison ingested, circumstances where poisoning occurs, and the outcome of these children in Hospital Universiti Sains Malaysia. A retrospective review of 184 medical records of children less than 12 years old admitted to Hospital Universiti Sains Malaysia between 1st January 1988 and 31st December 1993 with a discharge diagnosis of poisoning. One hundred and eight-four children were admitted to the Hospital Universiti Sains Malaysia during the period 1988-93 for ingestion of poison. This represents 1.7% of all paediatric admissions. One hundred and five (57.1%) children were boys giving a male:female ratio of 1.3:1. Most children (76%) were between 1-5 years old. In 119 (65%) of cases poisoning occurred in the child's own home. Only 44 (25.4%) of cases presented within one hour of ingestion or appearance of symptoms. The type of poison ingested included household products 107 (58.2%), medications 42 (22.8%) and others 35 (19%). Kerosene was the commonest agent (43.5%) followed by detergents and/or bleach (10.8%). Common medications ingested were analgesic drugs 11 (7.7%) and antipsychotic drugs 9 (6.3%). No children received ipecac before arrival and 17(9.2%) children had mechanically induced vomiting, including seven cases of kerosene and three cases of bleach ingestion. Four cases (2%) required intensive care and there were no fatalities. The total family income was less than RM300 per month in 75% of cases and only 7% of fathers and 2% of mothers had received tertiary education. Accidental poisoning, affecting predominantly toddlers between 1-5 years of age, was a common preventable condition in this hospital. Improved education for medical personnel and the public should diminish the number of children presenting with accidental ingestion of poison and their immediate management.