J Respir Med Lung Dis | Volume 8, Issue 1 | Research Article | Open Access
Shazi RS*, Mulaudzi M and Becker P
Department of Pediatrics, School of Medicine, University of Pretoria, South Africa
Fulltext PDFBackground: Young children are particularly susceptible to the ingestion of poisons, especially liquids, because they are very inquisitive. Most of the admitted children after accidentally ingesting poisons are asymptomatic and remain so during the admission period. However, there are no studies indicating the admission criteria of children with accidental paraffin poisoning taking into consideration time lapse post-exposure and the population at risk for mortality. This study set out to describe those patients not at risk to reduce the number of unnecessary admissions. Methods: This was a one-year prospective descriptive observational study at Kalafong Provincial Tertiary hospital from March 14th, 2017 to February 27th, 2018. Children with a diagnosis of accidental paraffin poisoning less than 5 years at emergency department were recruited into the study. Questionnaire was used to gather information. For discrete variables, Fisher’s exact test was used to compare groups. Continuous variables, student two sample T test was employed to compare groups. Results: A total of 52 children were recruited with accidental paraffin ingestion poisoning. The peak age group was 1 to 3 years with a mean of 22.7 months. Male predominance (61.5%) was noted with a ratio of 1.6:1. There was a seasonal preponderance to summer 18/52 (34.6%). Cough (71%), vomiting (71%), dyspnea (38.4%) were the dominant symptoms with (34/52 (65.4%) induced vomiting at home. The prevalence of chemical pneumonitis was 17.3% with no mortality. Predictors of development of chemical pneumonitis were hypoxia, respiratory distress, crepitations, wheezes, tachypnoea in the presence of significant fever of ≥ 38°C (p-value <0.05). Presence of respiratory distress, crepitations or wheezes, chemical pneumonitis and HIV status are the predictors of longer duration of hospitalization with (p-Values of 0.012, 0.001, 0.002 and 0.034 respectively). Other observed reasons for extended hospitalization were fever developing in the ward and children admitted on oxygen. Most patients 43 (82.7%) presented to hospital within 4 hours of ingestion. Over half 30 (57.7%) of patients were discharged from the hospital within first 24 h of admission. Conclusion: There is a need for a strategic planning with parental awareness programs to reduce paraffin ingestion poisoning and complications associated with prehospital care. Presence of respiratory distress, crepitation or wheezes; hypoxia in the presence of fever ≥ 38°C were associated with the development of chemical pneumonitis therefore is mandatory to admit these children. Respiratory distress, crepitations or wheezes, chemical pneumonitis, HIV status and parental age are the predictors of longer duration of hospitalization. We recommend that all children with paraffin ingestion poisoning should be observed for 6 h post-ingestion in emergency unit and if asymptomatic can be discharged with information on warning signs. Effective triage would likely cut down healthcare expenditure, duration of hospital stays, and effect on families of children with accidental paraffin poisoning.
Shazi RS, Mulaudzi M, Becker P. Clinical Profile and Outcome of Accidental Paraffin Ingestion in Children Under 5 Years as Seen at Kalafong Hospital. J Respir Med Lung Dis. 2023; 8(1): 1063..