Boyle Katherine L, Periyanayagam Usha, Babu Kavita M, Rice Brian T, Bisanzo Mark
From the Beth Israel Deaconess Medical Center.
Harvard Medical School.
Pediatr Emerg Care. 2020 Mar;36(3):e160-e162. doi: 10.1097/PEC.0000000000001265.
This study aims to describe pediatric poisonings presenting to a rural Ugandan emergency department (ED), identifying demographic factors and causative agents.
This retrospective study was conducted in the ED of a rural hospital in the Rukungiri District of Uganda. A prospectively collected quality assurance database of ED visits was queried for poisonings in patients under the age of 5 who were admitted to the hospital. Cases were included if the chief complaint or final diagnosis included anything referable to poisoning, ingestion, or intoxication, or if a toxicologic antidote was administered. The database was coded by a blinded investigator, and descriptive statistics were performed.
From November 9, 2009, to July 11, 2014, 3428 patients under the age of 5 were admitted to the hospital. A total of 123 cases (3.6%) met the inclusion criteria. Seventy-two patients were male (58.5%). The average age was 2.3 (SD, 0.97) years with 45 children (36.6%) under the age of 2 years. There were 19 cases (15.4%) lost to 3-day follow-up. The top 3 documented exposures responsible for pediatric poisonings were cow tick or organophosphates (36 cases, 29.2%), general poison or drug overdose (26 cases, 21.1%), and paraffin or hydrocarbon (24 cases, 19.5%).Of the admitted patients, 1 died in the ED and 2 died at 72-hour follow-up, for an overall 72-hour mortality of 2.4%. Patients who died were exposed to iron, cow tick, and rat poison.
Pediatric poisoning affects patients in rural sub-Saharan Africa. The mortality rate at one rural Ugandan hospital was greater than 2%.
本研究旨在描述乌干达农村急诊科收治的儿童中毒情况，确定人口统计学因素和致病原。
本回顾性研究在乌干达鲁昆吉里区一家农村医院的急诊科进行。前瞻性收集的急诊科就诊质量保证数据库用于查询5岁以下入院患儿的中毒情况。若主要诉求或最终诊断包括任何与中毒、摄入或中毒有关的内容，或给予了毒理学解毒剂，则纳入病例。数据库由一名盲法研究者编码，并进行描述性统计。
2009年11月9日至2014年7月11日，5岁以下患儿共123例（3.6%）符合纳入标准。72例为男性（58.5%）。平均年龄为2.3岁（标准差0.97），45名儿童（36.6%）年龄在2岁以下。19例（15.4%）失访3天。导致儿童中毒的前3种记录在案的暴露物为牛蜱或有机磷（36例，29.2%）、一般毒物或药物过量（26例，21.1%）以及石蜡或碳氢化合物（24例，19.5%）。在入院患者中，1例在急诊科死亡，2例在72小时随访时死亡，总体72小时死亡率为2.4%。死亡患者接触的是铁、牛蜱和鼠药。
儿童中毒影响撒哈拉以南非洲农村地区的患者。乌干达一家农村医院的死亡率超过2%。
