The epidemiology of acute childhood and adolescent poisoning in Thi-Qar governorate (2013-2015)


  • Raid Kareem Dehiol Department of pediatrics, college of medicine, Thi-Qar university


Epidemiology, Poisoning, Children, Adolescence


Background: acute childhood and adolescent poisoning remain one of the important emergencies causing a significant burden to the populations with important morbidity and mortality rates.                                                                                                                                  

Objectives: This study aimed to determine the epidemiological features of poisoning for the patients less than 19 years old in Al-Nasiriyah governorate, and to eliminate the main types, clinical presentations, management, outcome, and seasonal variation of poisoning. Epidemiological studies are so important to determine the extent of the problem, according to which the preventive strategies are related.                                                                                                                                           

Methods: A cross sectional retrospective study was conducted to three hundred forty patients recorded in Al-Nasiriyah poison center from (January 2013 to December 2015), data that collected from the case sheets and records of phone calls including the name, sex, address, type of poisoning, route of administration, management and the outcome of the patients (survive or died) are admitted to the SPSS (statistical package for social science) system and the results was obtained.                                                                                                                   

Results: two hundred (58.8%) of the exposed patients was male, toddler age group seen in 45% of cases with predominance of accidental type, while adolescents (>13-18yrs.) are mostly intentional with female preponderance, urban populations are more prone to poisoning 236 cases (69.4%), accidental exposure is the commonest (83.2%) oral route is the commonest (99.4%), (62.9%) of the causative agents are pharmaceutical, and (50.3%) are asymptomatic . most of them treated conservatively (96.5%) with survival rate of (97.9%), higher mortality seen in those presented after the first 24 hrs. of exposure. One third of acute poisoning was occurred in summer season. Easy accessibility to the drugs and toxic substances are the major risk factor.                                                                                                                  

Conclusion: Although poisoning is a preventable illness but, it is still a significant cause of morbidity and mortality especially in developing countries.  Acute poison has a significant impact on the health services.                                                                                           


Vazirian S, Mohamad Nejad M, Moqadasi A. poisoning epidemiology between admitted children in Razi and Shahid fahmideh hospitals in Kermanshah during 2002-2003 year. Kermanshah Med Uni J 2004; 8 (2): 29-36.

Centers for Disease Control and prevention (CDC). Increases in age group-specific injury mortality-united states, 1999_2004. MMWR Morb Mortal Wkly Rep. 2007; 56:1281-1284.

Gold Franks. Toxicologic Emergencies: Ninth ed., pp. 1790; 2011 Mc Graw Hill.

Elzbieta et al. Pattern of poisoning in urban and rural children: A single- center study. Adv Clin Med 2016; 25(2): 335-340.

G. C. Rodgers, Jr, et al. “poisonings” in Nelson’s Textbook of pediatrics, R. M. Kliegman, R.E. Behrman, H.B. Jenson, and B.F. Stanton, Eds. Saunders: Elsevier, , Philadelphia; 2008: 339-357.

Zawadzka-Gralec A, Zielin’ska-Duda H, Czerwionka-Szaflarskam, Wegrzynowska E, Kurylak D, Siwkas, Pufal E, Bloch-Boguslawska E, Sliwkak. Acute poisoning in children and Adolescent. Pediatr pol 2008; 83:373-379.

Bronstein Ac, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Ciffin SL.2008 Annual Report of the American Association of Poison Control Centers National Poison Data System (NPDS): 26th Annual Report. Clin Toxicol (phila) 2009; 47 (2): 911-1084.

Lamireau T, Lianas B, Kennedy A, Fayon M, Penouil F, Faverell-Garrigues Jc, Demarquez JL. Epidemiology of poisoning in children: A 7 year Survey in a pediatric emergency care unit. Eur J Emerg Med 2002; 9: 9-14.

Bukawska W, Szlagatys A, Korzon M: Intoxication in children and adolescents-new problems. Przegl Pediatr 2001; 31: 50-54.

Liebelt EL, De Angelis CD. Evolving trends and treatment advances in pediatric poisoning. JAMA 1999; 282 (12): 1113-15.

Iraq. Ministry of health / Planing directore, 219: 2010.

Winchester JF, Harbord NB, Rosen H. Management of poisonings: Core Curriculum 2010. Am J Kidney Dis 2010; 56 (4): 788-800.

Reith DM, Pitt WR, Hockey R. Childhood poisoning in Queensland: An analysis of presentation and admission rates. J Pediatr Child Health 2001; 37: 446-450.

Hockey R, Reith D, Miles E. Childhood Poisoning and ingestion. Injury Bull 2000; 60: 1-6.

Thomas WF, John HD, William RH. Stedman’s medical Dictionary. 28th ed. New York: Lippincott William and Wilkins; 2007. P. 2004.

Nhashi CF, Kasilo OM. The Pattern of poisoning in urban Zimbabwe. J Appl Toxicol 1992; 12: 435-438.

Hampe stead K. Manner of death and circumstances in fatal poisoning: Evidence from New Jersey. Injury prevention 2006; 12: 44.

Karen J. Marcdante, Robert M. Kliegman. Nelson’s, Essential of pediatrics, Elsevier Saunders; Canda, 7th ed: 2013: 139-144.

Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iran J Pediatric. 2011; 21: 479-84.

Halak Vasavada, Pankti Desai. Clinical Profile And outcome of Children presenting with poisoning C H Hospital Based Study. NJIRM. 2013; 4:1-7.

Hjern A, Ringback-weitoft G, Anderson R. Sociodemographic risk factors for hom-type injuries in Swedish infants and toddlers. Acta pediatric 2001; 90: 61-68.

Belson MG, Simon H K. Utility of comprehensive toxicologic screens in children. Am J Emerg Med 1999; 17: 221-4.

Kivisto JE, Arvola T, Parkkari J, Mattila VM: Pediatric poisoning treated in one finish main university hospital between 2002 and 2006. Acta pediatric 2008;97: 790-94.

Iraq. Ministry of Planning / Central Statistic Organization. Annual report 2014.

YR leveridge: the pattern of poisoning in costa Rica during 1997, Vet Hum Toxicol 41, 100-102 (1999).

M R Repetto: Epidemiology of poisoning due to pharmaceutical products, Poison Central Center, Seville, Spain. Eur J Epidemiology. 1997; 13: 353-356.

K Goto, Y Endoh, Y Kuroki and T Yoshioka: poisoning in children in Japan. Ind J Pediatric 1997; 64: 461-68 .

P. J. O’connor, Differentials in poisoning rates of young Australian children according to residential location and geographical remoteness, Injury prevention 2005;11(4): 204-206.

Basheir A, Hassan and Mohamed G. Siam: Pattern of Acute poisoning in childhood in zagazig, Egypt: An Epidemiological study. Hindawi Publishing Corporation, International Scholarly Research Notices 2014, Article ID 245279, 5 pages, 10.1155/2014/245279.

Nordentoft M. Prevention of suicide and attempted suicide in Denmark. Epidemiological studies of suicide and intervention studies in selected risk groups. Dan Med Bull 2007; 54: 306-369.

Farzaneh E, Mehrpour O, Alfred S, Monghaddam HH, Behnoush B, Seghatoleslam T. Self-poisoning suicide attempts among students in Tehran, Iran. Psychiatry Danub 2010; 22: 34-38.

Akhtar, R. G. Raj, and F. Al-Anezi, “Risk factors in acute poisoning in children: a retrospective study”, Kuwait medical Jaurnal,2006; vol. 38: 33-36.

Andrian N, Sarikayalar F, Pattern of acute poisoning in childhood in ankara: what has changed in twenty years? Turk J Pediatric 2004; 46: 147-152.

Mentegi S, Fernandez A, Alustiza J, Canduela V, Mongil I, Caubet I, et al, Emergency visitsfor childhood poisoning: a 2-year prospective multicenter survey in Spain, pediatric Emergency care 2006; 22:334-338.

Yan-Ren Lin, Tung-kung Wa, Tzu-An Liu, Chu-chung chou, Han-ping Wu, Poisoning Exposure and outcome of children admitted to a pediatric emergency department, Taiwan, china, changhua. World J Pediatr 2011;7(2):143-149

H.-L. lee, H.-J. Lin, S-Y Yeh, C.-H Chi, and H.-R Guo, “Etiology and outcome of patients presenting for poisoning to the emergency department in Taiwan: a prospective study, Human and Expiremental Toxicology.2008; 27(5) : 373-379.

K. L. Hon, J. K. Ho, T. F. Leung, Y. Wong, E. A. Nelson, and T. F, Fok, “review of children hospitalized for ingestion and poisoning at a tertiary center, Annals of the academy of medicine, 2005; 34(5): 356-361.

Kholod D. H., A three year review of accidental poisoning in children at Fatema AL-Zahra Teaching Hospital, Baghdad. The Iraqi postgraduate medical journal. 2006; Vol. 5, No. 3: 431-434.

Sabiha Sahin, M D, Kursat Bara Carman MD, and Ener Cargi Dinleyici, MD, acute poisoning in children; Data of pediatric Emergency unit, Iran J pediatric, Dec 2011; vol. 21(no. 4): 479-484.

Tetas Praiapati, et al. Acute chemical and pharmaceutical poisoning cases treated in Civil Hospital, APJMT 2; 2 June 2013.

Majid Abdul Wahab Maatook, Pattern of acute poisoning in children. Medical Journal of Babylon. 2014;vol. 11; no. 3:512-517.

Mutlu M, Gansu A, Karakas T, et al. Pattern of pediatric poisoning in the east Karadeniz region between 2002-2006: increased suicide poisoning. Hum Exp Toxicol 2010; 29(2):131.