TMSS Medical College Journal

Background and Objective: Acute poisoning is a medical emergency. It is an important public health problem causing significant morbidity and mortality throughout the world. Information available with regard to acute poisoning in Bangladesh is limited. It is important to know the nature, severity and outcome of acute poisoning cases in order to take up appropriate planning, prevention and management techniques. This study aimed to assess the pattern and outcome of acute poisoning cases in a tertiary care hospital in Bogra, Bangladesh. Materials and Methods: This is a retrospective hospital record-based study conducted in a tertiary care hospital attached to a medical college in Bogra. The study included 774 cases of acute poisoning due to drugs or chemicals and data regarding age, sex, circumstances of poisoning, name of the poisonous substance, chemical type, duration of hospitalization, and outcome were collected in the prestructured proforma. Results: Incidence was more common among males (66.28%) compared to females (33.78%) with male female ratio of 1.97 : 1 Most cases of acute poisoning presented among 20- to 29-year age group (39.15%) followed by 12- to 19-year age group (24.03%). A majority of poisoning cases (39.92%) were due to organophosphorus compound (OPC) followed by poisoning with unknown substance (19.76 %). Total mortality was found to be 10.08%. Mortality rate due to aluminium phosphide was significantly high (40.65%) compared to OPC poisoning (7.76%). Poisoning due to unknown substance and alcohol was found almost exclusively in males. Time lapse had a significant role on the mortality in cases of acute poisoning. Conclusion: Poisoning is more common in young males. The overall mortality is substantially high, mainly contributed by self-poisoning with aluminium phosphide and OPC. The incidence of poisoning and its morbidity and mortality can be reduced by developing and implementation of effective prevention strategies.

Poison is a substance that causes damage or injury to the body and endangers one’s life due to its exposure by means of ingestion, inhalation or contact '. Acute poisoning is defined as acute exposure (less than 24hrs) to the toxic substance 2 Acute poisoning is a major global health problem with significant morbidity and mortality affecting people of all age groups. Earlier reports demonstrated that everyday almost 700 people die from poisonings around the world and for every person that dies, several thousands more are affected by poisoning **. It is estimated that about 220000 people die every year as a result of poisoning particularly due to pesticide poisoning *. The exact magnitude of the problem can be elucidated by country or region wise epidemiological studies. Some hospital-based studies and public health surveillance reports clearly indicated increasing incidence of poisoning due to medications and chemicals particularly pesticides 57. The pattern of poisoning varies from country to country and region to region depending on factors like geography, accessibility and availability of poison,  socio-economic conditions, cultural and religious influences. In high income countries such as Norway, benzodiazepines, ethanol and paracetamol are the most common causes of poisoning *.In Bangladesh, the majority of the population is employed in agriculture, so poisoning due to pesticides and agrochemical products is more common .Poisoning is a serious threat in Bangladesh as it comprises around 14% of all deaths among adult females, 8% of all deaths among adult males and around 8 to 10% of overall mortality in medical wards of tertiary healthcare settings °. In general accidental poisoning is more common in children and suicidal poisoning is more common in young adults .Common types of poisoning in this country are organophosphorus compound (OPC) poisoning, poisoning with unknown substances ( stupefying poisoning) especially in commuter (travel-related) poisoning where patient cannot tell the name of poison or sign and symptoms does not indicate a specific poison ; aluminium phosphide poisoning poisoning with sedatives, corrosive agents, rodenticides, kerosene/petrol and alcohol, and snakebite®!. Of them, poisoning in commuters (commuter poisoning) has become a major toxicological issue in Bangladesh in the recent years ''. Some unusual forms of poisoning, such as copper sulfate and puffer fish poisoning are also occurred in some regions of the country *'>13, Epidemiological data on this important health issue are, however, scarce in northern part of Bangladesh. This study was carried out to describe the epidemiological profile of acute poisoning in part of northern Bangladesh and to evaluate the mortality rate.