A profile of community based acute poisoning and its associated mortality at the university teaching hospital in Lusaka in 2015

ABSTRACT Background: Acute poisoning remains a common method employed for suicide worldwide. World Health Organization (WHO) estimates that about 0.3 million people die every year worldwide due to various poisoning agents. Methodology: The study was a cross-sectional descriptive study. A retrospective survey of acute poisoning cases presenting at U.T.H medical emergency department was undertaken. This was conducted by identifying and reviewing all acute poisoning cases that presented at this department during the period 1st January, 2015 to 31th December, 2015 (a period of 12 months). A total of 131 patients’ medical records and charts on poisoning were reviewed. The data was thereafter analyzed by using statistical package of social science (SPSS). All statistical tests were at 5% significance level. Results: Of the 131 acute poisoning cases reviewed, 51.1% were female. Most patients (53.4%) were single and 47.3% were unemployed. Acute poisoning cases occurred more in the age-group of 20-39 years (49.6%). Most of poisoning cases (58.8%) occurred in areas associated with poor socio-economic status. Organophosphate poisoning accounted for (38.2%) of all the poisoning cases. Other common agents/drugs used were paracetamol tablets (7.6%), antibiotics (6.1%), antiretroviral (ARVs) (3.1%) and household chemicals (11.5%). Thirty four patients (26%) took more than one drug/ agent. Out of 109 patients who had the reason for their poisoning stated, 57 patients had relationship disharmony (32 married, 25 unmarried). Fourteen patients had family issues which mainly resulted from conflicts with parents and grandparents. The psychosocial problems of the 16 patients were not specified and accidental poisoning was seen in 5 patients. Majority of the patients (85.5%) were discharged without any complications and the mortality rate was observed at 4.6%. Low GCS (< 8) and hypothermia were common clinical features amongst patients that got admitted. The association between mortality and poisoning associated with alcohol was found to be statistically significant (p=0.04).
Conclusion: Acute poisoning is still a common phenomenon, majorly amongst females in the age group of 20 – 39 years, with poor quality of life. Relationship disharmony is the most common reason for poisoning. Organophosphate poisoning accounted for most of the poisoning cases. Drug/agent used can only be curtailed to a minimal extent. Prevention through early detection of vulnerable patients and early psychological management should be our goal.