Patterns and epidemiology of acute poisoning in Ethiopia: systematic review of observational studies

Abstract

BackgroundAcute poisoning is a common reason for emergency department visit and hospitalization worldwide with major morbidity and mortality. The burden of poisoning exposures in Africa is a significant public health concern, but only 10 of 58 countries have poisons information centers (PICs).ObjectiveThe primary intention of our current review is to explore and summarize the published evidence on the patterns and epidemiology of poisoning in Ethiopia.MethodPubMed and Scopus were searched for primary, case series and human studies for publications from inception to July 2017. A manual search for additional relevant studies using references from retrieved articles was also performed. Only studies that reported acute poisoning in both pediatric and adult patients were included. From the screened articles, data were extracted for baseline characteristics and relevant end points such as case fatality rate, time for health institution presentation and length of hospital stay.ResultInitial entry and search resulted in the retrieval of 332 articles. Finally, 9 studies comprised of 4763 participants were included in this current review. In 78% of the studies included in this review, acute poisoning is reported to be more prevalent in females. Acute poisoning was revealed to be prevalent in less than 30 years old. Organophosphates and household cleaning agents were the predominant agents of acute poisoning. Intentional poisoning was identified responsible for the majority of acute poisoning cases and factors such as psychiatric problems, and quarrel were identified as the underlying reasons for poisoning. Time of presentation to health institution after poisoning, length of hospital stay and case fatality rate were reported and lies in the ranges between 0.2 h–24 h, 0.5 days–17.7 days and 0–14.8%, respectively.ConclusionThe occurrence of acute poisoning was higher in females and common in less than 30 years of age, making this a real public health burden in Ethiopia. Psychiatric problems, quarrel and substance abuse were identified as the most common reasons for acute poisoning. Awareness creation how to handle chemicals and prescribed drugs and psychiatric consultations should be in place for the community.

<p>Prevalence, Predictors and Treatment Outcome of Acute Poisoning in Western Ethiopia</p>

“…20,21 In our study, the most vulnerable patients to poisoning were young adults (18 to 29 years). This result was comparable with the studies done in Ethiopia, 4 Kenya, 22 Iran, 19 and China. 15 The reason for the high rate of poisoning in young adults was partially explained by their vulnerability to stressful life situations and immaturity to cope up with the situation; thus, they would be easily emotional to decide suicide.…”

“…Yet the true prevalence might be more than this, due to uncommon practice of health-seeking practice of poisoned patients, 15 and the poor recording. 4 Even though data regarding the prevalence of acute poisoning are rare in Ethiopia, 4 it was reported to be as high as 0.67% to 1.1% of ED admission at Gondar, Northwest Ethiopia which is lower than the current data, 14,16 and in Tanzania 1.2%. 12 This is evidence that there is an increase in the rate of acute poisoning from time to time due to an increase in the availability of poisoning agents and social behavior as well as poor knowledge amongst users, 17,18 and weak controlling systems of agrochemicals, especially in LMICs.…”

“…[1][2][3] One systematic review and Meta-analysis in Ethiopia reported that the mortality rate of acute poisoning was in the range of 0% to 14.8%. 4 Acute poisoning is a significant global public health problem. 5,6 Acute poisoning cases are increasing day by day due to changes in lifestyle, availability of chemicals, and social behavior.…”

“…Besides, Ethiopia is among the countries that lack the poison center. 4 The prevalence of acute poisoning at ED was reported as 134/30,154 to 106/8827 (0.77% to 1.2%) by a few studies in Africa. [12][13][14] Even, that literature was failed to report the prevalence of acute poisoning in Ethiopia.…”

Development a national minimum data set for poisoning registry in Iran

“…Acute poisoning is one of the most common causes of emergency ward visits and hospitalization worldwide, which can lead to morbidity and mortality. 1 In the developing countries with high mortality rates, poisoning is considered to be one of the most common causes of admission to emergency rooms. 2 The World Health Organization (WHO) estimates that 0.3 million people die daily due to various poisoning agents.…”