Epidemiology, Clinical Profile and Outcome of Organophosphorous Poisoning in North-Western Rajasthan

Abstract

Introduction: Organophosphate pesticide poisoning (OPP) is continued to be a major global health problem especially in developing countries. This study was planned to evaluate epidemiological, clinical profile and outcome of OPP admitted in tertiary care hospital North West zone of Rajasthan, India. Materials and Methods: A total of 96 patients suffering from OP poisoning were evaluated for epidemiology, clinical profile and outcome. Diagnosis of OP poisoning was done by history, clinical examination and serum butyrylcholinesterase level assay. All patients were evaluated as per Performa and follow up till discharge. Severity of OPP was assessed by POP score and GCS score. Results: Out of 96 cases 76 were males 20 females, age ranging 14-55 years, mean age 26 ± 8, 85.4% were below age 30 years. Most of the patients were farmer, illiterate and belonging to rural area. Most common cause of poisoning was suicidal intention and most common route of poisoning was ingestion. Chlorpyrifos was the most common salt used followed by Monocrotophos, Phorate 10%, Dimethoate 30% and Quinalphos 25%. 8.3% had mild poisoning, 65.6% had moderately severe while 26% had severe OPP as evaluated by POP score. 19 patients required ventilator support, 10 cases developed ARDS and 6 had IMS. Mortality rate was 9.4%. Monocrotophos poison, amount of poison, long duration of poisoning, Hypokalemia, high bicarbonate level, high POP score and low GCS score were associated with poor outcome Conclusions: Thorough clinical evaluation is important for diagnosis and assessment of severity of OPP. POP score and GCS score help in assessing severity of OPP and its outcome. OPP is associated with life-threatening complications. Early detection and immediate treatment in intensive care units can increase the chances of survival rate in such cases. Banning of the most toxic pesticides may reduce the number of significant unintentional and intentional poisoning episodes.