Tagwireyi D, Ball D E, Nhachi C F B
Drug and Toxicology Information Service, Department of Pharmacy, University of Zimbabwe, Harare.
Clin Toxicol (Phila). 2006;44(3):233-41. doi: 10.1080/15563650600584279.
Toxicoepidemiological data from rural areas of developing countries is scarce. Most studies examine admissions to urban referral hospitals and extrapolate to lower level health facilities. The validity of this approach was examined in this work.
A retrospective review of all poisoning admissions was conducted at the provincial hospital (PH) and six district hospitals (DH) in Mashonaland Central province, Zimbabwe for the period January 1998 to December 1999 (inclusive). Patient records were traced by hand from medical ward registers. Relevant information was collected using a standard data collection tool.
There were 711 poisoning admissions to the DH and 341 to the PH. Case demographic details were similar at both the PH and DH, with a male to female ratio of 1:1 and most cases in the 0-5, 16-20 and 21-25 year age groups. Most admissions resulted from accidental poisoning (>60%) at both levels of care. However, the important causes of admission differed with animal envenomation (especially snakebite) predominating at DH (43.6% of admissions; 99% CI 38.9%-46.5%), whilst pesticide poisoning (26.1%; CI 20.0%-32.2%) predominated at the PH. Pharmaceutical exposures were common at the PH (15.2%; CI 10.2%-20.3%), but not at the DH (3.7%; CI 2.1%-5.1%). Despite this, patient demographics and reasons leading to poisoning were similar for animal, pesticide and pharmaceutical exposures.
Important differences existed between provincial and district poisoning data in Zimbabwe. Caution must be used when using urban referral hospital data to describe prevalence of poisoning in rural areas.
发展中国家农村地区的毒物流行病学数据匮乏。大多数研究调查的是城市转诊医院的入院情况，并据此推断较低层级医疗机构的情况。本研究对这种方法的有效性进行了检验。
对津巴布韦中马绍纳兰省的省级医院（PH）和六家区级医院（DH）在1998年1月至1999年12月（含）期间所有中毒入院病例进行回顾性研究。通过手工查阅医疗病房登记册追踪患者记录。使用标准数据收集工具收集相关信息。
区级医院有711例中毒入院病例，省级医院有341例。省级医院和区级医院的病例人口统计学细节相似，男女比例为1:1，大多数病例在0至5岁、16至20岁和21至25岁年龄组。在两个医疗层级中，大多数入院病例是由意外中毒导致的（>60%）。然而，入院的重要原因有所不同，区级医院以动物咬伤（尤其是蛇咬）为主（占入院病例的43.6%；99%置信区间38.9%-46.5%），而省级医院以农药中毒为主（26.1%；置信区间20.0%-32.2%）。药物暴露在省级医院很常见（15.2%；置信区间10.2%-20.3%），但在区级医院不常见（3.7%；置信区间2.1%-5.1%）。尽管如此，动物、农药和药物暴露的患者人口统计学特征和中毒原因相似。
津巴布韦省级和区级中毒数据存在重要差异。在使用城市转诊医院数据描述农村地区中毒患病率时必须谨慎。
