ACUTE POISONING AND ENVENOMATION IN CHILDREN: CLINICO-EPIDEMIOLOGICAL PROFILE AND OUTCOME IN CENTRAL NEPAL

Abstract

Background: Acute poisoning and envenomation are significant concerns among children, demanding specialized approaches. This study aimed to assess the current scenario, clinico-etiological profile and outcome of acute poisoning and envenomation in children within Bagmati province, excluding the valley area.

Methods: A retrospective observational analysis was conducted involving children aged 28 days and above to 18 years admitted to Chitwan Medical College’s Pediatric department between July 2020 to January 2023. Cases involving poison exposure or envenomation regardless of signs and symptoms, were included. Demographics, triage, interventions and outcomes were collected in predesigned data proforma and descriptive analysis was performed using SPSS 20.

Results: Results revealed, 179 admissions (3.49% of total) with most cases being accidental (87.3%), frequently among boys (64.8%) and age group 1-5 years old (53.1%) and median (IQR) age of 3 (2-8) years. Common presenting symptoms included vomiting (48%) and altered sensorium (21.2%). The median (IQR) time to hospital presentation post exposure was 3.75(2-7) hours. Organophosphorus (17.3%) and kerosene poisoning (8.4%) were the commonest poison, along with 11 cases of envenomation. Treatment included supportive care with antidote used in 17.9%. A majority (58.88%) only required 24- hour observation. There were a total of 5 deaths (2.79%) and 6 (3.35%) left against medical advice.

Conclusions: Our results align with previous similar studies conducted in Nepal and across Asia. Accidental cases predominated, particularly among young children. Organophosphorus remained a significant poison, while cypermethrin and alcohol poisoning were new observations. Basic supportive care saves more lives than all the antidotes put together.