An epidemiological of acute Pesticides poisoning in children presenting in emergency pediatric at Tishreen University Hospital during 2020-2023

Abstract

Objective: An epidemiological study of acute pesticide poisoning among children under 13 years of age attending in emergency pediatric at Tishreen University Hospital during 2020-2023 regarding to demographic, Prevalence, clinical manifestation,  management and  outcome.                                                                                

Material and methods: In an Observational Descriptive Cross Sectional  Study                                                                                                                                                     that included 67 consecutive patients (55.2% males vs. 44.8% females) of children attending Tishreen University Hospital in Lattakia during the period between January 2020 and January 2023 with a story of pesticide ingestion.

Results :The majority of cases  were from  2-6 years old  (62,7%)   ,ages between 6-12 years old  were  (28,4%) ,ages more 12 years old were( 6%,) ages younger 2 years old were ( 3%)  .The frequency of poisoning according seasons   shows that the majority of poisoning occurred in Summer(43,3%),in  Autumn(26,9 %) ,in  Spring(25,4%) and in winter( 4,4%   )  . Insecticides :Pyrmethr and perytroid were the most common cause of Pesticides poisoning(25,4%) ,then  Organophosphate compounds(11,9) , Naphtaline (11,9%) ,Carbamate and Organochlor compounds (7,5 %) ,and finally Chlorfenapyr (3%). Rodenticides:Warfarin was the most common cause (23,8), then Zinc Phosphide (4,5%) , finaly Arsenic (3%).Herbicides :Parquate was (1,5%).

-  23 children were admitted in pediatric department (34,3%) and  5 children were admitted in the intensive care unit (7,5%). No deaths  recorded                                                                                                                                 

Symptoms and clinical signs:   vomiting and abdominal pain were in 25 cases (37,3%) ,coma was in 12 cases (18%) ,miosis was in 12 cases (18%) ,cough , acute renal failure were  in 1 case (1,5%)  , bronchospasm was in 3 cases (4,5%) ,upper digestive hemorrhage , epistaxis, anemia  were  in 1 case (1,5%). Gastric lavage was performed in 44 cases (65,7%) ,Activated charcoal was given in 30 cases (44,8%) . specific Antidots  were used in 27 cases (40%) 13 of them  recived   Atropin(19,4%), 8 recived   Pralidoxim (12%),14 recived  Vitamin K1 (preventive dose  10 mg one dose ) ( 12%) and 1 child  resived Vk1( therapeutic dose 10mg x 4  for 3 days)(1,5%).Oral ingestion was the main rout of toxicity  in our study (92%), by inhalation  it was in ( 4,5%)    and the  dermal rout was in  (4,5 %).  83,6 % of cases were indoors .There was no mortality in our study .