Childhood and adolescent poisoning: a prospective analysis from the largest poison control centre

BACKGROUND: Childhood and adolescent poisoning is a significant health problem globally, especially in low- and middle- income countries. Globally, around a million childhood cases of poisoning were reported in 2019. In Pakistan, unintentional childhood and adolescent poisoning is higher, including organophosphates, snake bites, and animal bites. Therefore, this study aims to identify the most common agents causing poisoning, risk factors, management, and outcomes of childhood and adolescent poisoning incidents. METHODS: This study included childhood and adolescent poisoning cases from March to May 2025 presented at Jinnah Postgraduate Medical Center Karachi, Pakistan. A total of 110 children were included in the study between the ages of 0-18 years. Exposure was poisoning, and there were two outcomes: length of hospital stay (days) and status on follow-up (alive/dead). Acute poisoning was suspected in children who presented a clear history of recent exposure, fast onset of symptoms, and clinical characteristics such as vomiting, altered level of consciousness, convulsions, respiratory distress, aberrant pupil size, or distinctive odor. Organophosphate poisoning was diagnosed based on clear exposure history, identification of substance containers, presence of classical cholinergic toxidrome (vomiting, salivation, lacrimation, pinpoint pupils, fasciculations) and clinical response to atropine. Chi-square and Fisher's exact test were performed, considering a p-value < 0.05 being significant. RESULTS: The median age was 17 years with an equal distribution of males and females. Organophosphate poisoning (60.91%) was the most reported poisoning, followed by snake bites (21.82%). Only one (0.91%) case had prior poisoning history. Around 82.00% of poisoning cases occurred at home, and 58.18% of cases occurred due to deliberate intent. Organophosphate poisoning (p < 0.001), median respiratory rate of 20 (p = 0.034), and heart rate of 100 (p = 0.007), were significantly associated with longer hospital stay. CONCLUSION: This study highlights organophosphate poisoning as the most common cause, often intentional and occurring at home due to easier access and unsafe storage. This study helps in the identification of patients who are prone to a longer hospital stay than others, providing clinicians with a means to personalize patient care.