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Pediatr Emerg Care. 2017 Oct 9. doi: 10.1097/PEC.0000000000001265. [Epub ahead of print]

Pediatric Poisonings in a Rural Ugandan Emergency Department.

Author information

1
From the *Beth Israel Deaconess Medical Center; †Harvard Medical School, ‡Brigham and Women's Hospital, Boston; §Global Emergency Care Collaborative, Shrewsbury; ∥University of Massachusetts Medical School, Worcester, MA, ¶New York University School of Medicine, New York, NY, #University of Vermont College of Medicine, Burlington, VT.

Abstract

OBJECTIVE:

This study aims to describe pediatric poisonings presenting to a rural Ugandan emergency department (ED), identifying demographic factors and causative agents.

METHODS:

This retrospective study was conducted in the ED of a rural hospital in the Rukungiri District of Uganda. A prospectively collected quality assurance database of ED visits was queried for poisonings in patients under the age of 5 who were admitted to the hospital. Cases were included if the chief complaint or final diagnosis included anything referable to poisoning, ingestion, or intoxication, or if a toxicologic antidote was administered. The database was coded by a blinded investigator, and descriptive statistics were performed.

RESULTS:

From November 9, 2009, to July 11, 2014, 3428 patients under the age of 5 were admitted to the hospital. A total of 123 cases (3.6%) met the inclusion criteria. Seventy-two patients were male (58.5%). The average age was 2.3 (SD, 0.97) years with 45 children (36.6%) under the age of 2 years. There were 19 cases (15.4%) lost to 3-day follow-up. The top 3 documented exposures responsible for pediatric poisonings were cow tick or organophosphates (36 cases, 29.2%), general poison or drug overdose (26 cases, 21.1%), and paraffin or hydrocarbon (24 cases, 19.5%).Of the admitted patients, 1 died in the ED and 2 died at 72-hour follow-up, for an overall 72-hour mortality of 2.4%. Patients who died were exposed to iron, cow tick, and rat poison.

CONCLUSIONS:

Pediatric poisoning affects patients in rural sub-Saharan Africa. The mortality rate at one rural Ugandan hospital was greater than 2%.

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