Dayasiri M B Kavinda Chandimal, Jayamanne Shaluka F, Jayasinghe Chamilka Y
University Paediatrics Unit, Lady Ridgeway Hospital for Children, Colombo, Sri Lanka.
Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka.
Int J Pediatr. 2017;2017:4375987. doi: 10.1155/2017/4375987. Epub 2017 Aug 8.
Acute poisoning in children is a major preventable cause of morbidity and mortality in both developed and developing countries. However, there is a wide variation in patterns of poisoning and related risk factors across different geographic regions globally. This hospital based case-control study identifies the risk factors of acute unintentional poisoning among children aged 1-5 years of the rural community in a developing Asian country.
This hospital based case-control study included 600 children. Each group comprised three hundred children and all children were recruited at Anuradhapura Teaching Hospital, Sri Lanka, over two years (from February 2012 to January 2014). The two groups were compared to identify the effect of 23 proposed risk factors for unintentional poisoning using multivariate analysis in a binary logistic regression model.
Multivariate analysis identified eight risk factors which were significantly associated with unintentional poisoning. The strongest risk factors were inadequate supervision (95% CI: 15.4-52.6), employed mother (95% CI: 2.9-17.5), parental concern of lack of family support (95% CI: 3.65-83.3), and unsafe storage of household poisons (95% CI: 1.5-4.9).
Since inadequate supervision, unsafe storage, and unsafe environment are the strongest risk factors for childhood unintentional poisoning, the effect of community education to enhance vigilance, safe storage, and assurance of safe environment should be evaluated.
在发达国家和发展中国家,儿童急性中毒都是发病和死亡的一个主要可预防原因。然而,全球不同地理区域的中毒模式及相关风险因素存在很大差异。这项基于医院的病例对照研究确定了一个亚洲发展中国家农村社区1至5岁儿童急性非故意中毒的风险因素。
这项基于医院的病例对照研究纳入了600名儿童。每组包括300名儿童,所有儿童均于两年内(2012年2月至2014年1月)在斯里兰卡阿努拉德普勒教学医院招募。通过二元逻辑回归模型中的多变量分析对两组进行比较,以确定23个提出的非故意中毒风险因素的影响。
多变量分析确定了八个与非故意中毒显著相关的风险因素。最强的风险因素是监管不足(95%置信区间:15.4 - 52.6)、母亲就业(95%置信区间:2.9 - 17.5)、父母担心缺乏家庭支持(95%置信区间:3.65 - 83.3)以及家用毒物储存不安全(95%置信区间:1.5 - 4.9)。
由于监管不足、储存不安全和环境不安全是儿童非故意中毒的最强风险因素,应评估社区教育在提高警惕、安全储存和确保安全环境方面的效果。