Acute ingestion poisoning in children: Insights from a 15-month analysis in pediatric emergency care
Keywords:
outcomes, acute ingestion, poisoning children, retrospective analysis, emergency, pediatric care, patterns, accidental, intentional, toxicologyAbstract
Background and aim: Acute pediatric poisonings remain a major global health problem. They constitute a frequent reason for emergency medical consultations and are among the leading causes of death and morbidity worldwide. This study aims to evaluate the extent of accidental and suicidal intoxication by ingestion in children and to describe its epidemiologic and clinical characteristics.
Methods: Our study was conducted at the pediatric emergency department of the Children’s Hospital in Rabat. It involved a retrospective descriptive analysis spanning 15 months, from October 1, 2020, to December 31, 2021. We included all acute intoxications in children aged 1 month to 18 years due to ingestion of toxic substances such as medications, caustic products, pesticides, cannabis derivatives, and plants.
Results: The study included 221 cases of poisoned children, the M/F sex ratio was 1.12. Accidental poisoning was predominant (86%) and the severity of intoxication was mostly minor (42.5%). Baby walkers were the most affected (56.3%). Drug poisonings were prevalent (46%) dominated by nervous system medications, followed by caustic substance exposures (31.7%). Pesticide intoxications accounted for 15%, while cannabis derivatives and plant ingestions represented 4.5% and 2.8%, respectively. The clinical symptoms varied significantly based on the responsible toxic agent.
Conclusions: Acute pediatric poisoning is a critical health challenge, especially in children. Most intoxications occur accidentally, with medications being the primary implicated toxic agents. In pediatrics, the consequences of poisoning are mostly benign, However, this apparent harmlessness should not lead us to ignore prophylactic measures that are widely effective.
References
Celegen M. Epidemiologic and clinical evaluation of the acute intoxication in pediatric patients. Health Sci Q. 2021;1(2):69-73. Accessed February 13, 2024. https://dergipark.org.tr/en/pub/hsq/issue/64929/996564
Bkiyar H, Alouani I, Ahsayan K, et al. Profil épidémiologique des intoxications aiguës en service de réanimation du centre hospitalier régional Al Farabi : à propos de 121 cas. Anesth Réanimation. 2015;1:A259. doi:10.1016/j.anrea.2015.07.396
Mousannif S, Mefetah H, Zhim I, Bouatia M. 4CPS-199 Pharmaco-economic impact of drug intoxications in children. Published online 2023. Accessed May 22, 2024. https://ejhp.bmj.com/content/30/Suppl_1/A90.1.abstract
Wong KU, Baum CR. Acute Cannabis Toxicity. Pediatr Emerg Care. 2019;35(11):799-804. doi:10.1097/PEC.0000000000001970
Berta GN, Di Scipio F, Bosetti FM, et al. Childhood acute poisoning in the Italian North-West area: a six-year retrospective study. Ital J Pediatr. 2020;46(1):83. doi:10.1186/s13052-020-00845-0
Singh SP, Aggarwal AD, Oberoi SS, et al. Study of poisoning trends in north India – A perspective in relation to world statistics. J Forensic Leg Med. 2013;20(1):14-18. doi:10.1016/j.jflm.2012.04.034
Wang L, Wu Y, Yin P, et al. Poisoning deaths in China, 2006–2016. Bull World Health Organ. 2018;96(5):314-326A. doi:10.2471/BLT.17.203943
Rhalem N, al. RAPPORT GENERAL 2020 DE TOXICOVIGILANCEOXICOVIGILANCE MAROC. Toxicol. Maroc Publ. Off. Cent. Anti Poison Maroc Ministère Santé, vol. 49, p. 3‑7, mars 2021.
Sanae A, Amal B, Abourazzak S, et al. LES ASPECTS EPIDEMIOLOGIQUES DES INTOXICATIONS AIGUES CHEZ L’ENFANT AU MAROC (1980-2009). Toxicol Maroc Publ Off Cent Anti Poison Maroc Ministère Santé. 2012;12:5-8.
Fabresse N, Alvarez JC. Épidémiologie des intoxications aiguës. Toxicol Anal Clin. 2020;32(4):291-300. doi:10.1016/j.toxac.2020.06.004
Lahcen O, Rhalem N, Rachida A, et al. Profil épidémiologique des intoxications au Maroc de 1980 à 2007. Toxicol Maroc. 2009;N° 3.
Hajar R, Bencheikh R, Hami H, et al. Aspects épidémiologiques des intoxications survenues dans la région de Fès-Boulemane, Maroc (2007-2011). Sci Vivant Pharm. 2013;5.
Bronstein AC, Spyker DA, Cantilena LR, et al. 2007 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol Phila Pa. 2008;46(10):927-1057. doi:10.1080/15563650802559632
Goullé JP, Lhermitte M, Bartholi M, et al. Biomarqueurs de toxicité et anomalies métaboliques dans les principales intoxications graves. Symptomatologie clinique et toxique. Le prélèvement conservatoire. Ann Toxicol Anal. 2003;15:208-212. doi:10.1051/ata/2003026
Lee J, Fan NC, Yao TC, et al. Clinical spectrum of acute poisoning in children admitted to the pediatric emergency department. Pediatr Neonatol. 2019;60(1):59-67. doi:10.1016/j.pedneo.2018.04.001
Azab SMS, Hirshon JM, Hayes BD, et al. Epidemiology of acute poisoning in children presenting to the poisoning treatment center at Ain Shams University in Cairo, Egypt, 2009-2013. Clin Toxicol Phila Pa. 2016;54(1):20-26. doi:10.3109/15563650.2015.1112014
Andiran N, Sarikayalar F. Pattern of acute poisonings in childhood in Ankara: what has changed in twenty years? Turk J Pediatr. 2004;46(2):147-152.
Gokalp G. Evaluation of poisoning cases admitted to pediatric emergency department. Int J Pediatr Adolesc Med. 2019;6(3):109-114. doi:10.1016/j.ijpam.2019.07.004
Brissaud O, Chevret L, Claudet I. Severe intoxication with drugs and/or illicit substances admitted to intensive care units: Pediatric specificities. Med Ther Pediatr. 2008;11:331-339. doi:10.1684/mtp.2008.0185
Ozdemir R, Bayrakci B, Tekşam O, Yalçin B, Kale G. Thirty-three-year experience on childhood poisoning. Turk J Pediatr. 2012;54(3):251-259.
Mignonsin D, Yassibana S, Camara B, et al. INTOXICATION PAR LES PRODUITS CAUSTIQUES : ETUDE EPIDEMIOLOGIQUE ET APPROCHE THERAPEUTIQUE. Médecine Afr Noire. Published online 1992.
G. J, Badrane N, Rhalem N, et al. Intoxications par les produits caustiques et irritants: Données du Centre Antipoison du Maroc. Toxicol Maroc. 2013;18:3-4.
Johannsen HG. [Poisoning accidents with household chemicals among children in the period 1993-2002 compared with the period 1980-1992]. Ugeskr Laeger. 2006;168(1):51-55.
Abidli Z, Jadda S, Detsouli A, et al. Profil épidémiologique des intoxications par les pesticides chez les enfants au Maroc. Toxicol Anal Clin. 2019;31(2, Supplement):S58-S59. doi:10.1016/j.toxac.2019.03.086
Achour S, Khattabi A, Rhalem N, et al. L’intoxication par les pesticides chez l’enfant au Maroc : profil épidémiologique et aspects pronostiques (1990-2008). Santé Publique. 2011;23(3):195-205. doi:10.3917/spub.113.0195
Coret A, Rowan-Legg A. Unintentional cannabis exposures in children pre- and post-legalization: A retrospective review from a Canadian paediatric hospital. Paediatr Child Health. 2022;27(5):265-271. doi:10.1093/pch/pxab090
Cheng P, Zargaran A, Rajabali F, Turcotte K, Babul S. Original quantitative research - Setting the baseline: a description of cannabis poisonings at a Canadian pediatric hospital prior to the legalization of recreational cannabis. Health Promot Chronic Dis Prev Can Res Policy Pract. 2020;40(5-6):193-200. Accessed February 16, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367428/
Graham J, Leonard J, Banerji S, Wang GS. Illicit Drug Exposures in Young Pediatric Patients Reported to the National Poison Data System, 2006-2016. J Pediatr. 2020;219:254-258.e1. doi:10.1016/j.jpeds.2019.11.004
Chartier C, Penouil F, Blanc-Brisset I, Pion C, Descatha A, Deguigne M. Pediatric cannabis poisonings in France: more and more frequent and severe. Clin Toxicol Phila Pa. 2021;59(4):326-333. doi:10.1080/15563650.2020.1806295
Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol Phila Pa. 2017;55(10):1072-1252. doi:10.1080/15563650.2017.1388087
Mousannif S, Meftah A, Cheikh A, Bouatia M. Children Voluntary Intoxications: Cases of Attempted Suicide. Drug Saf. 2022;45(10):1143-1143. Accessed May 22, 2024. https://search.proquest.com/openview/6fb4f43cc864671d732e8261f7c1fc7a/1?pq-origsite=gscholar&cbl=32187
Benzeid H, Gouaz F, Touré AH, Bouatia M, Idrissi MOB, Draoui M. Inventory of toxic plants in Morocco: an overview of the botanical, biogeography, and phytochemistry studies. J Toxicol. 2018;2018. Accessed May 22, 2024. https://www.hindawi.com/journals/jt/2018/4563735/abs/
dawi.com/journals/jt/2018/4563735/abs/
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