Acute OP Poisoning in a Tribal District of Odisha: An Experience from a Tertiary Care Hospital

Introduction: Acute organophosphate (OP) poisoning remains a significant public health challenge in agricultural regions, with limited epidemiological and clinical characterization available for vulnerable tribal populations. This study aimed to evaluate the sociodemographic patterns of acute OP poisoning in a tribal district of Odisha and assess the correlation between clinical severity, serum acetylcholinesterase (AChE) levels, and other biochemical markers. Objectives: To study the socio-demographic pattern of OP poisoning in the tribal population. To correlate the serum AChE level with clinical severity of OP poisoning based on POP scaling system. Methods: A cross-sectional observational study was conducted involving 95 patients aged >12 years with confirmed acute OP exposure admitted within 24 hours to SLN Medical College and Hospital, Koraput. Clinical severity was stratified at admission using the Peradeniya Organophosphorus Poisoning (POP) scale into mild (0–3), moderate (4–7), and severe (8–11) categories. Serum AChE, renal function parameters, and electrolytes were evaluated alongside clinical outcomes. Results: Males accounted for 65.3% () of cases, with the highest vulnerability observed in the 20–40 age group (51.5%, ). The majority of patients were illiterate (40.0%, ) and unemployed (30.5%, ), followed by farmers (22.1%, ). Suicidal intent accounted for 94.7% () of ingestions, predominantly triggered by family disturbances (40.0%, ) and relationship distress (30.5%, ). According to the POP scale, 68.4% presented with mild, 24.2% with moderate, and 7.4% with severe poisoning. Serum AChE activity demonstrated a steep inverse correlation with clinical severity, dropping from in mild cases to in severe cases. Worsening severity was accompanied by elevated serum creatinine ( in mild vs. in severe), hypernatremia, and hypokalemia ( vs. ). Overall mortality was 10.5% () and exhibited a significant positive correlation with the admission POP score (, ), reaching 71.4% among severe presentations. Conclusions: Admission POP scores combined with serum AChE, creatinine, and electrolyte monitoring serve as effective prognostic indicators in acute OP toxicity. Mitigating pesticide mortality in these vulnerable populations necessitates timely clinical-biochemical triage alongside targeted psychosocial support and regulatory pesticide controls.