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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Paediatric poisoning in rural Sri Lanka: an epidemiological study

Authors: Godakanda Arachchige Maneesha Prasadi, Fahim Mohamed, Lalith Senarathna, Rose Cairns, Pahala Hangidi Gedara Janaka Pushpakumara, Andrew Hamilton Dawson

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Acute paediatric poisoning is a common public health concern for both developed and developing countries. The type of agent and underlying cause differ depending on the social, cultural, economic and educational background. The objectives of this study were to identify the incidence and pattern of paediatric poisoning in a rural district in Sri Lanka and establish whether tertiary referral hospital data are a useful surrogate for estimating district level epidemiology of paediatric poisoning.

Methods

A subset of epidemiological data were obtained from March 2011 to February 2013 from a randomized controlled trial (SLCTR/2010/008) conducted in 45 hospitals in Kurunegala district.

Results

The age adjusted annual incidence of all cause of acute poisoning in children aged 1 to 12 years in the study area was 60.4 per 100,000. The incidence of poisoning of younger age group (1 to 6 years; 76 per 100,000) was significantly higher than older age group (7 to 12 years; 41 per 100,000) (p = 0.0001) in Kurunegala district. The annual incidence rate of paediatric admissions due to deliberate self-poisoning is 18 per 100,000 population. This study also established that admission data from primary hospitals provided the most accurate epidemiological information on paediatric poisoning.

Conclusions

In rural districts of Sri Lanka, acute paediatric poisoning cases were less frequent and less severe compared to adult poisoning cases (426–446 per 100,000 population). The incidence of poisoning was significantly higher among young children with compared to old children. In this study, deliberate self-poisoning among older children was more frequently seen than in other comparable countries. Because most of the admissions are directed to and managed by primary hospitals, data from referral hospitals alone cannot be used to represent the true incidence of acute poisoning within a district. The data set from all the primary hospitals (n = 44) yielded more accurate poisoning incidence amongst a paediatric population.
Literature
1.
go back to reference Taft C, Paul H, Consunji R, Miller T. Childhood unintentional injury worldwide: meeting the challenge. Washington: SAFE KIDS worldwide; 2002. Taft C, Paul H, Consunji R, Miller T. Childhood unintentional injury worldwide: meeting the challenge. Washington: SAFE KIDS worldwide; 2002.
2.
go back to reference Peden M. World report on child injury prevention: World Health Organization; 2008. Peden M. World report on child injury prevention: World Health Organization; 2008.
3.
go back to reference Cheng DR, Ip CCK. Unintentional paediatric poisoning in rural Victoria: incidence and admission rates. Aust J Rural Health. 2012;20(6):339–43.CrossRefPubMed Cheng DR, Ip CCK. Unintentional paediatric poisoning in rural Victoria: incidence and admission rates. Aust J Rural Health. 2012;20(6):339–43.CrossRefPubMed
4.
go back to reference Hassan BA, Siam MG. Patterns of acute poisoning in childhood in Zagazig, Egypt: an epidemiological study. Int Sch Res Notices. 2014;2014. Hassan BA, Siam MG. Patterns of acute poisoning in childhood in Zagazig, Egypt: an epidemiological study. Int Sch Res Notices. 2014;2014.
5.
go back to reference Ram P, Kanchan T, Unnikrishnan B. Pattern of acute poisonings in children below 15 years–a study from Mangalore, South India. J Forensic Legal Med. 2014;25:26–9.CrossRef Ram P, Kanchan T, Unnikrishnan B. Pattern of acute poisonings in children below 15 years–a study from Mangalore, South India. J Forensic Legal Med. 2014;25:26–9.CrossRef
6.
7.
go back to reference Machin D, Campbell MJ. The design of studies for medical research: John Wiley & Sons; 2005. Machin D, Campbell MJ. The design of studies for medical research: John Wiley & Sons; 2005.
8.
go back to reference Manzar N, Saad SM, Manzar B, Fatima SS. The study of etiological and demographic characteristics of acute household accidental poisoning in children-a consecutive case series study from Pakistan. BMC Pediatr. 2010;10(1):28.CrossRefPubMedPubMedCentral Manzar N, Saad SM, Manzar B, Fatima SS. The study of etiological and demographic characteristics of acute household accidental poisoning in children-a consecutive case series study from Pakistan. BMC Pediatr. 2010;10(1):28.CrossRefPubMedPubMedCentral
9.
go back to reference Kleinbaum DG, Sullivan KM, Barker ND. How to set things up? Study designs. A Pocket Guide to Epidemiology 2007:21–41. Kleinbaum DG, Sullivan KM, Barker ND. How to set things up? Study designs. A Pocket Guide to Epidemiology 2007:21–41.
10.
go back to reference Mutlu M, Cansu A, Karakas T, Kalyoncu M, Erduran E. Pattern of pediatric poisoning in the east Karadeniz region between 2002 and 2006: increased suicide poisoning. Hum Exp Toxicol. 2010;29(2):131–6.CrossRefPubMed Mutlu M, Cansu A, Karakas T, Kalyoncu M, Erduran E. Pattern of pediatric poisoning in the east Karadeniz region between 2002 and 2006: increased suicide poisoning. Hum Exp Toxicol. 2010;29(2):131–6.CrossRefPubMed
11.
go back to reference Dayasiri M, Jayamanne S, Jayasinghe Y. Trends in paediatric poisoning in the north-Central Province of Sri Lanka. 2013. Dayasiri M, Jayamanne S, Jayasinghe Y. Trends in paediatric poisoning in the north-Central Province of Sri Lanka. 2013.
12.
go back to reference Coben JH, Tiesman HM, Bossarte RM, Furbee PM. Rural–urban differences in injury hospitalizations in the US, 2004. Am J Prev Med. 2009;36(1):49–55.CrossRefPubMed Coben JH, Tiesman HM, Bossarte RM, Furbee PM. Rural–urban differences in injury hospitalizations in the US, 2004. Am J Prev Med. 2009;36(1):49–55.CrossRefPubMed
13.
go back to reference Reith D, Pitt W, Hockey R. Childhood poisoning in Queensland: an analysis of presentation and admission rates. J Paediatr Child Health. 2001;37(5):446–50.CrossRefPubMed Reith D, Pitt W, Hockey R. Childhood poisoning in Queensland: an analysis of presentation and admission rates. J Paediatr Child Health. 2001;37(5):446–50.CrossRefPubMed
14.
go back to reference Allocca S. Sharp rise in poisonings among teen girls baffles researchers. Rockaway: Forensic magazine. Accessed 18 May 2016 Allocca S. Sharp rise in poisonings among teen girls baffles researchers. Rockaway: Forensic magazine. Accessed 18 May 2016
15.
go back to reference Kohli U, Kuttiat VS, Lodha R, Kabra S. Profile of childhood poisoning at a tertiary care Centre in North India. Indian J Pediatr. 2008;75(8):791–4.CrossRefPubMed Kohli U, Kuttiat VS, Lodha R, Kabra S. Profile of childhood poisoning at a tertiary care Centre in North India. Indian J Pediatr. 2008;75(8):791–4.CrossRefPubMed
16.
go back to reference Tyrrell EG, Orton E, Tata LJ. Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study. Inj Prev. 2016;22(6):400–6.CrossRefPubMed Tyrrell EG, Orton E, Tata LJ. Changes in poisonings among adolescents in the UK between 1992 and 2012: a population based cohort study. Inj Prev. 2016;22(6):400–6.CrossRefPubMed
17.
go back to reference Mbeledogu CN, Cecil EV, Millett C, Saxena S. Hospital admissions for unintentional poisoning in preschool children in England; 2000–2011. Arch Dis Child. 2015;100(2):180–2.CrossRefPubMed Mbeledogu CN, Cecil EV, Millett C, Saxena S. Hospital admissions for unintentional poisoning in preschool children in England; 2000–2011. Arch Dis Child. 2015;100(2):180–2.CrossRefPubMed
18.
go back to reference Rajka T, Heyerdahl F, Hovda KE, Stiksrud B, Jacobsen D. Acute child poisonings in Oslo: a 2-year prospective study. Acta Paediatr. 2007;96(9):1355–9.CrossRefPubMed Rajka T, Heyerdahl F, Hovda KE, Stiksrud B, Jacobsen D. Acute child poisonings in Oslo: a 2-year prospective study. Acta Paediatr. 2007;96(9):1355–9.CrossRefPubMed
19.
go back to reference Fernando R, Fernando DN. Childhood poisoning in Sri Lanka. Indian J of Pediatr. 1997;64(4):457–60.CrossRef Fernando R, Fernando DN. Childhood poisoning in Sri Lanka. Indian J of Pediatr. 1997;64(4):457–60.CrossRef
20.
go back to reference Eddleston M, Sudarshan K, Senthilkumaran M, Reginald K, Karalliedde L, Senarathna L, et al. Patterns of hospital transfer for self-poisoned patients in rural Sri Lanka: implications for estimating the incidence of self-poisoning in the developing world. Bull World Health Organ. 2006;84(4):276–82.CrossRefPubMedPubMedCentral Eddleston M, Sudarshan K, Senthilkumaran M, Reginald K, Karalliedde L, Senarathna L, et al. Patterns of hospital transfer for self-poisoned patients in rural Sri Lanka: implications for estimating the incidence of self-poisoning in the developing world. Bull World Health Organ. 2006;84(4):276–82.CrossRefPubMedPubMedCentral
21.
go back to reference Senarathna L, Buckley N, Jayamanna S, Kelly P, Dibley M, Dawson A. Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka. Bull World Health Organ. 2012;90(6):436–a.CrossRefPubMedPubMedCentral Senarathna L, Buckley N, Jayamanna S, Kelly P, Dibley M, Dawson A. Validity of referral hospitals for the toxicovigilance of acute poisoning in Sri Lanka. Bull World Health Organ. 2012;90(6):436–a.CrossRefPubMedPubMedCentral
22.
go back to reference Eddleston M, Gunnell D, Karunaratne A, De Silva D, Sheriff MR, Buckley NA. Epidemiology of intentional self-poisoning in rural Sri Lanka. Br J Psychiatry. 2005;187(6):583–4.CrossRefPubMedPubMedCentral Eddleston M, Gunnell D, Karunaratne A, De Silva D, Sheriff MR, Buckley NA. Epidemiology of intentional self-poisoning in rural Sri Lanka. Br J Psychiatry. 2005;187(6):583–4.CrossRefPubMedPubMedCentral
23.
go back to reference Senarathna L, Jayamanna SF, Kelly PJ, Buckley NA, Dibley MJ, Dawson AH. Changing epidemiologic patterns of deliberate self poisoning in a rural district of Sri Lanka. BMC Public Health. 2012;12(1):593.CrossRefPubMedPubMedCentral Senarathna L, Jayamanna SF, Kelly PJ, Buckley NA, Dibley MJ, Dawson AH. Changing epidemiologic patterns of deliberate self poisoning in a rural district of Sri Lanka. BMC Public Health. 2012;12(1):593.CrossRefPubMedPubMedCentral
24.
go back to reference Ministry of Health, N. I. M.. Raising the age limit for provision of paediatric care up to 14 years. 2016. Ministry of Health, N. I. M.. Raising the age limit for provision of paediatric care up to 14 years. 2016.
25.
go back to reference Census and Statistics SL. Census of Population and Housing 2012. 2012. Census and Statistics SL. Census of Population and Housing 2012. 2012.
26.
go back to reference Mohamed F, Endre ZH, Buckley NA. Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries. Br J Clin Pharmacol. 2015;80:3–19.CrossRefPubMedPubMedCentral Mohamed F, Endre ZH, Buckley NA. Role of biomarkers of nephrotoxic acute kidney injury in deliberate poisoning and envenomation in less developed countries. Br J Clin Pharmacol. 2015;80:3–19.CrossRefPubMedPubMedCentral
27.
go back to reference Mohamed F, Endre ZH, Pickering JW, Jayamanne S, Palangasinghe C, Shahmy S, Chathuranga U, Wijerathna T, Shihana F, Gawarammana I. Mechanism-specific injury biomarkers predict nephrotoxicity early following glyphosate surfactant herbicide (GPSH) poisoning. Toxicol Lett. 2016;258:1–10.CrossRefPubMed Mohamed F, Endre ZH, Pickering JW, Jayamanne S, Palangasinghe C, Shahmy S, Chathuranga U, Wijerathna T, Shihana F, Gawarammana I. Mechanism-specific injury biomarkers predict nephrotoxicity early following glyphosate surfactant herbicide (GPSH) poisoning. Toxicol Lett. 2016;258:1–10.CrossRefPubMed
28.
go back to reference Hon K, Ho J, Leung TF, Wong Y, Nelson E, Fok TF. Review of children hospitalised for ingestion and poisoning at a tertiary Centre. Ann Acad Med Singapore. 2005;34(5):356.PubMed Hon K, Ho J, Leung TF, Wong Y, Nelson E, Fok TF. Review of children hospitalised for ingestion and poisoning at a tertiary Centre. Ann Acad Med Singapore. 2005;34(5):356.PubMed
29.
go back to reference Balme KH, Robert JC, Glasstone M, Curling L, Rother HA, London L, Zar H, Mann MD. Pesticide poisonings at a tertiary children's hospital in South Africa: an increasing problem. Clin Toxicol. 2010;48(9):928–34.CrossRef Balme KH, Robert JC, Glasstone M, Curling L, Rother HA, London L, Zar H, Mann MD. Pesticide poisonings at a tertiary children's hospital in South Africa: an increasing problem. Clin Toxicol. 2010;48(9):928–34.CrossRef
30.
go back to reference Dutta A, Seth A, Goyal P, Aggarwal V, Mittal S, Sharma R, et al. Poisoning in children: Indian scenario. Indian J Pediatr. 1998;65(3):365–70.CrossRefPubMed Dutta A, Seth A, Goyal P, Aggarwal V, Mittal S, Sharma R, et al. Poisoning in children: Indian scenario. Indian J Pediatr. 1998;65(3):365–70.CrossRefPubMed
31.
go back to reference Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self harm in adolescents: self report survey in schools in England. BMJ. 2002;325(7374):1207–11.CrossRefPubMedPubMedCentral Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self harm in adolescents: self report survey in schools in England. BMJ. 2002;325(7374):1207–11.CrossRefPubMedPubMedCentral
32.
go back to reference Krishnakumar P, Geeta M, Gopalan A. Deliberate self-poisoning in children. Indian Pediatr. 2005;42(6):582.PubMed Krishnakumar P, Geeta M, Gopalan A. Deliberate self-poisoning in children. Indian Pediatr. 2005;42(6):582.PubMed
33.
go back to reference Sinno D, Majdalani M, Chatila R, Musharrafieh U, Al-Tannir M. The pattern of self-poisoning among Lebanese children and adolescents in two tertiary care centres in Lebanon. Acta Paediatr. 2009;98(6):1044–8.CrossRefPubMed Sinno D, Majdalani M, Chatila R, Musharrafieh U, Al-Tannir M. The pattern of self-poisoning among Lebanese children and adolescents in two tertiary care centres in Lebanon. Acta Paediatr. 2009;98(6):1044–8.CrossRefPubMed
34.
go back to reference Hawton K, Haw C, Casey D, Bale L, Brand F, Rutherford D. Self-harm in Oxford, England: epidemiological and clinical trends, 1996-2010. Soc Psychiatry Psychiatr Epidemiol. 2015;50(5):695.CrossRefPubMed Hawton K, Haw C, Casey D, Bale L, Brand F, Rutherford D. Self-harm in Oxford, England: epidemiological and clinical trends, 1996-2010. Soc Psychiatry Psychiatr Epidemiol. 2015;50(5):695.CrossRefPubMed
35.
go back to reference Brian HKW, Clarice H, Kua EH. Suicidal behavior among young people in Singapore. Gen Hosp Psychiatry. 1999;21(2):128–33.CrossRef Brian HKW, Clarice H, Kua EH. Suicidal behavior among young people in Singapore. Gen Hosp Psychiatry. 1999;21(2):128–33.CrossRef
36.
go back to reference Finkelstein Y, Macdonald EM, Hollands S, Sivilotti ML, Hutson JR, Mamdani MM, et al. Risk of suicide following deliberate self-poisoning. JAMA Psychiatry. 2015;72(6):570–5.CrossRefPubMed Finkelstein Y, Macdonald EM, Hollands S, Sivilotti ML, Hutson JR, Mamdani MM, et al. Risk of suicide following deliberate self-poisoning. JAMA Psychiatry. 2015;72(6):570–5.CrossRefPubMed
37.
go back to reference Lin Y-R, Liu T-H, Liu T-A, Chang Y-J, Chou C-C, Wu H-P. Pharmaceutical poisoning exposure and outcome analysis in children admitted to the pediatric emergency department. Pediatr Neonatology. 2011;52(1):11–7.CrossRef Lin Y-R, Liu T-H, Liu T-A, Chang Y-J, Chou C-C, Wu H-P. Pharmaceutical poisoning exposure and outcome analysis in children admitted to the pediatric emergency department. Pediatr Neonatology. 2011;52(1):11–7.CrossRef
38.
go back to reference Zakharov S, Navratil T, Pelclova D. Suicide attempts by deliberate self-poisoning in children and adolescents. Psychiatry Res. 2013;210(1):302–7.CrossRefPubMed Zakharov S, Navratil T, Pelclova D. Suicide attempts by deliberate self-poisoning in children and adolescents. Psychiatry Res. 2013;210(1):302–7.CrossRefPubMed
39.
go back to reference Kivistö JE, Arvola T, Parkkari J, Mattila VM. Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006. Acta Paediatr. 2008;97(6):790–4.CrossRefPubMed Kivistö JE, Arvola T, Parkkari J, Mattila VM. Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006. Acta Paediatr. 2008;97(6):790–4.CrossRefPubMed
40.
41.
go back to reference Hawton K, Fagg J, Simkin S. Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976-1993. Br J Psychiatry. 1996;169(2):202–8.CrossRef Hawton K, Fagg J, Simkin S. Deliberate self-poisoning and self-injury in children and adolescents under 16 years of age in Oxford, 1976-1993. Br J Psychiatry. 1996;169(2):202–8.CrossRef
42.
go back to reference Lucas G.. A hospital based prospective study of acute childhood poisoning. 2006. Lucas G.. A hospital based prospective study of acute childhood poisoning. 2006.
43.
go back to reference Dayasiri M, Jayamanne SF, Jayasinghe CY. Plant poisoning among children in rural Sri Lanka. Int J Pediatr 2017;2017. Dayasiri M, Jayamanne SF, Jayasinghe CY. Plant poisoning among children in rural Sri Lanka. Int J Pediatr 2017;2017.
44.
go back to reference Dayasiri M, Jayamanne SF, Jayasinghe CY. Kerosene oil poisoning among children in rural Sri Lanka. Int J Pediatr 2017;2017. Dayasiri M, Jayamanne SF, Jayasinghe CY. Kerosene oil poisoning among children in rural Sri Lanka. Int J Pediatr 2017;2017.
45.
go back to reference Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iran J Pediatr. 2011;21(4):479.PubMedPubMedCentral Sahin S, Carman KB, Dinleyici EC. Acute poisoning in children; data of a pediatric emergency unit. Iran J Pediatr. 2011;21(4):479.PubMedPubMedCentral
46.
go back to reference Krug A, Ellis J, Hay I, Mokgabudi N, Robertson J. The impact of child-resistant containers on the incidence of paraffin (kerosene) ingestion in children. S Afr Med J. 1994;84(11):730–4.PubMed Krug A, Ellis J, Hay I, Mokgabudi N, Robertson J. The impact of child-resistant containers on the incidence of paraffin (kerosene) ingestion in children. S Afr Med J. 1994;84(11):730–4.PubMed
47.
go back to reference Maisel G, Langdoc BA, Jenkins MQ, Aycock EK. Analysis of two surveys evaluating a project to reduce accidental poisoning among children. Public Health Rep. 1967;82(6):555.CrossRefPubMedPubMedCentral Maisel G, Langdoc BA, Jenkins MQ, Aycock EK. Analysis of two surveys evaluating a project to reduce accidental poisoning among children. Public Health Rep. 1967;82(6):555.CrossRefPubMedPubMedCentral
48.
Metadata
Title
Paediatric poisoning in rural Sri Lanka: an epidemiological study
Authors
Godakanda Arachchige Maneesha Prasadi
Fahim Mohamed
Lalith Senarathna
Rose Cairns
Pahala Hangidi Gedara Janaka Pushpakumara
Andrew Hamilton Dawson
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-6259-y

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