Demographic Characteristics, Clinical Manifestations, Treatment, and Outcomes of Organophosphate Poisoning at Abu Ali Sina Balkhi Regional Hospital, Afghanistan: A Retrospective Case Series

ABSTRACT: Background: Organophosphate poisoning is an important cause of acute pesticide toxicity and can result in cholinergic manifestations, respiratory failure, and death. Its clinical outcomes depend on the circumstances of exposure, severity of poisoning, timeliness of presentation, and availability of appropriate treatment. Objective: To describe the demographic characteristics, clinical manifestations, treatment, and outcomes of patients with organophosphate poisoning admitted to Abu Ali Sina Balkhi Regional Hospital, Afghanistan, during the Afghan calendar year 1404 Solar Hijri. Methods: A retrospective descriptive case series was conducted using 128 patient records supplied for analysis. The dataset included demographic information, type and route of exposure, reported circumstances of poisoning, clinical manifestations, antidote administration, mechanical ventilation, length of hospital stay, and treatment outcomes. Descriptive statistics were used to summarize the available data. Results: The dataset contained 128 patients aged 18–80 years. The mean age was 27.1 years (standard deviation [SD], 11.0), and the median age was 25 years. Females accounted for 99 patients (77.3%) and males for 29 (22.7%). Fenitrothion-containing indoor insecticide powder was recorded in 124 cases (96.9%), while malathion agricultural insecticide was recorded in four cases (3.1%). Gastrointestinal exposure was recorded in 124 cases (96.9%), and dermal exposure in four (3.1%). Atropine and pralidoxime were documented for all patients. Four patients (3.1%) required mechanical ventilation. Three patients died in hospital, giving a recorded case-fatality proportion of 2.3%; 125 patients (97.7%) were recorded as having recovered. The calculated mean hospital stay was 6.9 days. Conclusion: In this hospital-based series, most recorded cases involved gastrointestinal exposure to fenitrothion-containing insecticide powder, and most patients were young adults. The recorded in-hospital case-fatality proportion was 2.3%. These findings provide a preliminary description of organophosphate poisoning in this setting. Further investigation of poisoning circumstances, clinical severity, and treatment details are needed before broader conclusions can be drawn.