Acute poisoning in children in Ethiopia: a cross-sectional study

Poisonings are a widespread public health issue that endangers the wellbeing of the general population and are one of the most frequent reasons for hospital admissions. Their yearly prevalence varies by nation, and even by province inside a single nation¹¹. The current hospital-based retrospective study was conducted on the most difficult medical condition for which Ethiopia lacks adequate epidemiological clarification. It entailed looking into medical records of poisoning cases involving children (0–18 years) over 4 years.

According to Mowry et al., children under the age of six make up roughly half of all toxin exposure cases in the United States¹². 60.68% of poisoning cases in India include children under the age of six, according to Bhat et al.¹³. According to Al-Barraq and Farahat, children under the age of five account for the bulk of child poisoning incidents in Saudi Arabia¹⁴. According to Oliveira and Suchara, children under the age of four in Brazil account for the majority of poisoning cases¹⁵. The results of all these studies were consistent with the findings of this research. The majority of the poisoning victims were aged between 0 and 5 years (42.68%), followed by ages between 11 and 18 years (accounting for 32.9%). This indicates that poisoning was most prevalent in children who were exposed to toxic agents accidentally and in adults who were largely intentionally exposed.

According to the current study, males are more likely than females to become poisoned as children. This is supported by several studies that have been conducted around the world^12,16,17. The fact that males are more active than females might be one of the explanations for this. The precise cause, however, is unknown¹⁶.

In our study, most poisoned patients have low self or parental educational status. This is because most poisoned children are under 5 years old and most parents are from rural areas where educational access is actually low.

Our study showed that the number of poisoned children was higher in rural areas than that of urban areas (65.9% vs 34.1%), in which children poisoning admission rates have been consistently higher in rural areas than urban areas. This is probably due to the fact that parental educational status is low in rural areas (39 vs 7) and some poisons are more common in rural areas like insecticides.

Both accidental and intentional poisoning are possible. According to this study’s findings, accidental poisoning accounts for 75.61% of all poisoning cases, which is consistent with research conducted by three pediatric referral hospitals in Addis Abeba³. The oral route was documented in the majority of poisoned cases (69.5%), which was similar to the results obtained at Jimma and Tikur Anbesa, Ethiopia^10,18.

Venoms (snakebite) were the most common agent implicated in our poisoned patients. This could be explained by the fact that we are living in an area where snakes are abundant and poor practices of bite prevention and risk reduction like working in forests.

Organophosphate poisoning was the second most prevalent agent. These results were similar to those of other studies held in Jimma¹⁰. This could be explained by the fact that we are living in one of the major agricultural areas in Ethiopia, and the easy access and inappropriate usage of insecticides are common.

Rural residency was the independent factor of death treatment outcomes for acute poisoning, and it was approximately three times more likely to contribute to a death treatment outcome than urban residency. Furthermore, poisoning via the digestive tract is approximately 2.5 times more likely to result in a dying treatment outcome than other poisoning routes, since exposure status > 1 h increases the likelihood of a dying treatment outcome approximately 6 times more than 1 h of hospital arrival. Longer hospital stays may result in patients with more serious conditions, which may affect the outcome of their medical care—death.

The main drawback of this study is that it was retrospective, which led to missing patient data. Another limitation was that it was a single-center; retrospective study with a limited sample size, so findings might not be generalized.

Poisoning can be reduced through the use of effective prevention strategies by avoiding poisoning agents from the environment (e.g., removal of poisonous plants and removal of insecticides out of reach of children), enforcement of child-resistant packaging of necessary poisonous agents (e.g., medicines, household chemicals, and other toxins), and wearing protective equipment like shoes for snake bite. Hence, studies with larger samples and population-level data from both urban and rural areas could provide better estimates of the prevalence and risk factors for poisoning. Furthermore, it is essential to educate the public about poisoning prevention, early referral, and care. Despite the limitations mentioned above, we conducted a 6-year retrospective study to determine the prevalence and short-term outcome of poisoning in children. This study alarms researchers for further study at a multicenter level.