Abstract
Background: Pesticide poisoning is very common in Tunisia. Various factors are involved in the analysis of the clinical presentations and the severity of this condition. Major factors are the chemical nature of the pesticides and the quantity entered the body. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Fifty cases pesticide poisoning were admitted to the hospital between January 2013 and October 2016. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. The poisoning was accidental in 49 cases and self-inflicted in one, with the mode being oral (N=45), respiratory (N=2) and cutaneous (N=3). The average duration of hospital care for these patients was 2 hours and 30 minutes (range: 30 min-24 hr). The clinical manifestations of poisoning noted were due to muscarinic and nicotinic receptors inhibition. Upon clinical examination, 29 patients had no pesticide in the gastric lavage fluid and urine and demonstrated no abnormal cholinesterase activity. The therapeutic management was mainly symptomatic with antidote medications prescribed (atropine and oxime). All patients had favorable outcomes and no death occurred. Conclusion: This study demonstrated the frequency of pesticide poisoning in a pediatric setting and the importance of early management. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.
Highlights
The main targets of pesticides are various living organisms, such as fungi, weeds, insects, mites, nematodes, mollusks, and rodents
Insecticides including organophosphates (OP) and carbamates are the main causes of acute pesticides poisoning in children [1, 2]
Pesticide poisoning is very common in Tunisia and ranks the 3rd highest according to recent reports from the Emergency Medical Assistance Center (CAMU)
Summary
The main targets of pesticides are various living organisms, such as fungi, weeds, insects, mites, nematodes, mollusks, and rodents. The clinical presentations of acute poisoning result from the inhibition of cholinesterase receptors at the synaptic junctions or the effects on erythrocytes in plasma. The presentation includes three syndromes: muscarinic, nicotinic and encephalic that may coexist in the same patient. The aim of this study was to examine the epidemiological, clinical and therapeutic characteristics of acute pesticide poisoning in children and to propose the optimal preventive measures. Methods: This is a retrospective study, reporting the pediatric cases that presented to us with signs and symptoms of pesticide poisoning. Results: A total of 50 pediatric cases were included in this study with the mean age of 3 years and 4months. Optimal therapeutic approaches were evaluated, demonstrating that prevention still remains the best solution in such cases.
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