Pattern of Acute Pediatric Poisoning at Assiut University Hospitals

Overview

Acute pediatric poisoning is a common worldwide problematic emergency and represents frequent cause of emergency department admissions throughout the world. In 2017, the 35th Annual Report of the American Association of Poison Control Centers' National Poison Data System referred more than 2 million calls for cases of human exposure to toxic substance, more than 50% of them occurred in children less than 13 years old. Also, about 1030 patients less than 14 years old were acutely intoxicated and presented to the Regina Margherita Hospital in Italy from 2012 to 2017. According to Ain Shams study during the period between 2009 and 2013, acute poisoning presented to Ain Shams Poison Control Center; accounts for an estimated 38,470 case among children less than or equals to 18 years old. In the same age group mentioned above, about 760 cases admitted to Menoufia Poison Control Center during the year 2016, those between 2 and 6 years represented the highest age group. Although pediatric poisoning represents a major and preventable cause of morbidity and mortality throughout the world, usually there is a great challenge with the management of acute pediatric poisoning due to the fact of difficult history taking, unreliable examination compared with that of an adult, in addition, pediatric patients are usually more vulnerable due to physiological difference between developmental stages. Also, the evident curiosity for the surroundings and the desire to explore and to emulate adults, make children particularly exposed to acute intoxications.

In pediatric poisoning, the age, distribution, causes of poisoning and types of products involved differ between different geographical areas, even in the same area etiology and demographics of pediatric poisoning may change over the time depending on accessibility of poisoning to child, socioeconomic level, education, local beliefs, and customs. So, surveillance of epidemiology and patterns of children acute poisoning in each country is beneficial to define the scope of the problem and its management regarding prevention and treatment. Acute pediatric poisoning may be unintentional (accidental, therapeutic error), or intentional (suicide, substance abuse). Unintentional poisoning is common in preschool age, mostly due to non-pharmaceutical agents, the most frequent agent of them is caustic ingestion according to Ain Shams Poison Control Center study. Caustic chemicals are widely distributed in our environment, caustic exposure is a lifelong and global problem associated with severe tissue and mucous membrane injuries with an estimated 80% of its exposure occurring among children. Caustic exposure is among the leading causes of mortality in those younger than 5 years, more than 15.8 cases per 100,000 children in the USA are reported annually, the situation is more severe in developing countries. While the developed world has accurate demographic date about acute pediatric poisoning and its incidence, this major health problem is still insufficiently studied in the developing world and poorly documented. To knowledge, Assiut University Hospitals are lacking good demographic and epidemiological data regarding pediatric poisoning.