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Introduction. Les intoxications aiguës représentent une urgence fréquente et potentiellement mortelle, mais leurs caractéristiques restent peu documentées dans les villes camerounaises. Cette étude visait à décrire le profil clinique, les agents en cause et l'évolution des patients pris en charge pour intoxication aiguë dans deux hôpitaux de référence de Douala. Méthodes. Nous avons mené une étude rétrospective sur cinq ans (2009–2013) incluant tous les patients hospitalisés pour intoxication aiguë dans les services d'urgences, réanimation, médecine interne, pédiatrie, gastro-entérologie, néphrologie, pneumologie et psychiatrie de l'Hôpital Général de Douala et de l'Hôpital Laquintinie. Les données sociodémographiques, cliniques, thérapeutiques et évolutives ont été analysées. Résultats. 123 patients répondaient aux critères d'inclusion. L'âge médian était de 27 ans (intervalle interquartile 15–37), avec une légère prédominance masculine (sex-ratio 1,12). Les intoxications étaient accidentelles dans 84,3 % des cas, survenaient au domicile (95,1 %) et par ingestion (92,7 %). Les principaux agents toxiques étaient les médicaments (24,4 %), les produits caustiques (23,6 %) et les pesticides (22,0 %). Les signes cliniques dominants étaient respiratoires (53,7 %), digestifs (51,2 %) et neurologiques (43,9 %). Le délai de consultation était d'une à trois heures pour 47,8 % des patients. La prise en charge reposait sur un traitement symptomatique (91,9 %) et évacuateur (54,5 %), avec administration d'antidotes dans 24,4 % des cas. Des complications sont survenues chez 25,4 % des patients. L'évolution était favorable dans 91 % des cas ; 11 patients (9,0 %) sont décédés. Conclusion. À Douala, les intoxications aiguës touchent principalement des adultes jeunes, surviennent accidentellement à domicile et sont dominées par l'ingestion de médicaments, caustiques et pesticides. Malgré un traitement rapide, la mortalité reste élevée (9 %), justifiant le renforcement de la prévention et l'optimisation des protocoles de prise en charge d'urgence.
ABSTRACT
Introduction. Acute poisonings are frequent and potentially life‑threatening emergencies, yet their characteristics remain poorly documented in Cameroonian cities. This study aimed to describe the clinical profile, causative agents, and outcomes of patients managed for acute poisoning in two referral hospitals in Douala. Methods. We conducted a five‑year (2009–2013) retrospective study including all patients hospitalized for acute poisoning in the emergency, intensive care, internal medicine, pediatrics, gastroenterology, nephrology, pulmonology, and psychiatry departments of Douala General Hospital and Laquintinie Hospital. Sociodemographic, clinical, therapeutic, and outcome data were analyzed. Results. 123 patients met the inclusion criteria. Median age was 27 years (interquartile range 15–37), with a slight male predominance (sex ratio 1.12). Poisonings were accidental in 84.3% of cases, occurred at home (95.1%), and involved ingestion (92.7%). The main toxic agents were pharmaceuticals (24.4%), caustic products (23.6%), and pesticides (22.0%). Dominant clinical signs were respiratory (53.7%), digestive (51.2%), and neurological (43.9%). Time to presentation was one to three hours for 47.8% of patients. Management included symptomatic treatment (91.9%) and gastric decontamination (54.5%); antidotes were administered in 24.4% of cases. Complications occurred in 25.4% of patients. Outcome was favorable in 91% of cases; 11 patients (9.0%) died. Conclusion. In Douala, acute poisonings predominantly affect young adults, occur accidentally at home, and are dominated by ingestion of pharmaceuticals, caustics, and pesticides. Despite rapid presentation, mortality remains high (9%), underscoring the need for strengthened prevention and optimized emergency management protocols.
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References
- 1. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Rivers LJ, Feldman R, Brown K, Pham NPT, Bronstein AC, DesLauriers C. 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th Annual Report. Clin Toxicol (Phila). oct 2023;61(10):717‑939.
- 2. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Rivers LJ, Feldman R, Brown K, Pham NPT, Bronstein AC, DesLauriers C. 2023 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 41st Annual Report. Clin Toxicol (Phila). déc 2024;62(12):793‑1027.
- 3. Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister G, Konradsen F, Murray D, Piola JC, Senanayake N, Sheriff R, Singh S, Siwach SB, Smit L. Pesticide poisoning in the developing world--a minimum pesticides list. Lancet. 12 oct 2002;360(9340):1163‑7.
- 4. Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. déc 2003;32(6):902‑9.
- 5. Mew EJ, Padmanathan P, Konradsen F, Eddleston M, Chang SS, Phillips MR, Gunnell D. The global burden of fatal self-poisoning with pesticides 2006-15: Systematic review. J Affect Disord. sept 2017;219:93‑104.
- 6. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 21 déc 2007;7:357.
- 7. Lee YY, Chisholm D, Eddleston M, Gunnell D, Fleischmann A, Konradsen F, Bertram MY, Mihalopoulos C, Brown R, Santomauro DF, Schess J, van Ommeren M. The cost-effectiveness of banning highly hazardous pesticides to prevent suicides due to pesticide self-ingestion across 14 countries: an economic modelling study. Lancet Glob Health. mars 2021;9(3):e291‑300.
- 8. Chyka PA, Seger D, Krenzelok EP, Vale JA, American Academy of Clinical Toxicology, European Association of Poisons Centres and Clinical Toxicologists. Position paper: Single-dose activated charcoal. Clin Toxicol (Phila). 2005;43(2):61‑87.
- 9. Persson HE, Sjöberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol. 1998;36(3):205‑13.
- 10. Tunwashe OL, Odukoya OO, Atiba JO. Acute poisoning in the emergency room in Lagos University Teaching Hospital. Trop Doct. oct 1985;15(4):164‑6.
- 11. Ouédraogo M, Ouédraogo M, Yéré S, Traoré S, Guissou IP. Acute intoxications in two university hospitals in Burkina Faso. Afr Health Sci. déc 2012;12(4):483‑6.
- 12. Kouéta F, Dao L, Yé D, Fayama Z, Sawadogo A. [Acute accidental poisoning in children: aspects of their epidemiology, aetiology, and outcome at the Charles de Gaulle Paediatric Hospital in Ouagadougou (Burkina Faso)]. Sante. 2009;19(2):55‑9.
- 13. Getie A, Belayneh YM. A Retrospective Study of Acute Poisoning Cases and Their Management at Emergency Department of Dessie Referral Hospital, Northeast Ethiopia. Drug Healthc Patient Saf. 2020;12:41‑8.
- 14. Waktola LG, Melese EB, Mesfin N, Altaye KD, Legese GL. Prevalence of unfavorable outcome in acute poisoning and associated factors at the University of Gondar comprehensive specialized hospital, Gondar, Northwest Ethiopia: a hospital-based cross-sectional study. Front Public Health. 2023;11:1160182.
- 15. Ajeigbe AK, Adedeji TA, Jeje OA, Olukoyejo OE, Bello MB, Ogra VO, Jokanola OJ, Ajose OA. Profile of Acute Poisoning among Adult Patients at the Emergency Room of a Tertiary Hospital, South-western Nigeria. West Afr J Med. 28 sept 2023;40(9):920‑4.
- 16. Areprekumor TE, Joboy-Okei E, Amadin NO, Kalu SU. Patterns and clinical outcomes of childhood poisoning presenting to a children’s emergency department in Yenagoa, Nigeria: a 10-year retrospective study. BMJ Paediatr Open. 15 mai 2024;8(1):e002433.
- 17. Pouokam GB, Lemnyuy Album W, Ndikontar AS, Sidatt MEH. A Pilot Study in Cameroon to Understand Safe Uses of Pesticides in Agriculture, Risk Factors for Farmers’ Exposure and Management of Accidental Cases. Toxics. 1 nov 2017;5(4):30.
- 18. Goga R, de Vasconcellos K, Singh D. Acute poisonings presenting to King Edward VIII hospital intensive care unit in Durban, South Africa. South Afr J Crit Care. 2021;37(1).
- 19. Baydin A, Yardan T, Aygun D, Doganay Z, Nargis C, Incealtin O. Retrospective evaluation of emergency service patients with poisoning: a 3-year study. Adv Ther. 2005;22(6):650‑8.
- 20. Zöhre E, Ayrık C, Bozkurt S, Köse A, Narcı H, Çevik İ, Toker İ, Demir F, Ovla D. Retrospective analysis of poisoning cases admitted to the emergency medicine. Arch Iran Med. févr 2015;18(2):117‑22.
- 21. Reed RP, Conradie FM. The epidemiology and clinical features of paraffin (kerosene) poisoning in rural African children. Ann Trop Paediatr. mars 1997;17(1):49‑55.
- 22. Lifshitz M, Sofer S, Gorodischer R. Hydrocarbon poisoning in children: a 5-year retrospective study. Wilderness Environ Med. 2003;14(2):78‑82.
- 23. Ngobese A, Govender S, Peer N, Sheik-Gafoor MH. Caustic ingestion in children treated at a tertiary centre in South Africa: can upper endoscopy be omitted in asymptomatic patients? Pediatr Surg Int. mars 2022;38(3):505‑12.
- 24. Boyle KL, Periyanayagam U, Babu KM, Rice BT, Bisanzo M. Pediatric Poisonings in a Rural Ugandan Emergency Department. Pediatr Emerg Care. mars 2020;36(3):e160‑2.
- 25. Ikhile I, Chijioke-Nwauche I, Orisakwe OE. Childhood Drug and Non-Drug Poisoning in Nigeria: An Economic Appraisal. Ann Glob Health. 9 juill 2019;85(1):100.
- 26. Orisakwe OE, Egenti L, Orish C. Childhood non-drug poisoning in Nnewi, Nigeria. Trop Doct. oct 2000;30(4):209‑11.
References
1. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Rivers LJ, Feldman R, Brown K, Pham NPT, Bronstein AC, DesLauriers C. 2022 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 40th Annual Report. Clin Toxicol (Phila). oct 2023;61(10):717‑939.
2. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Rivers LJ, Feldman R, Brown K, Pham NPT, Bronstein AC, DesLauriers C. 2023 Annual Report of the National Poison Data System® (NPDS) from America’s Poison Centers®: 41st Annual Report. Clin Toxicol (Phila). déc 2024;62(12):793‑1027.
3. Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister G, Konradsen F, Murray D, Piola JC, Senanayake N, Sheriff R, Singh S, Siwach SB, Smit L. Pesticide poisoning in the developing world--a minimum pesticides list. Lancet. 12 oct 2002;360(9340):1163‑7.
4. Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. déc 2003;32(6):902‑9.
5. Mew EJ, Padmanathan P, Konradsen F, Eddleston M, Chang SS, Phillips MR, Gunnell D. The global burden of fatal self-poisoning with pesticides 2006-15: Systematic review. J Affect Disord. sept 2017;219:93‑104.
6. Gunnell D, Eddleston M, Phillips MR, Konradsen F. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 21 déc 2007;7:357.
7. Lee YY, Chisholm D, Eddleston M, Gunnell D, Fleischmann A, Konradsen F, Bertram MY, Mihalopoulos C, Brown R, Santomauro DF, Schess J, van Ommeren M. The cost-effectiveness of banning highly hazardous pesticides to prevent suicides due to pesticide self-ingestion across 14 countries: an economic modelling study. Lancet Glob Health. mars 2021;9(3):e291‑300.
8. Chyka PA, Seger D, Krenzelok EP, Vale JA, American Academy of Clinical Toxicology, European Association of Poisons Centres and Clinical Toxicologists. Position paper: Single-dose activated charcoal. Clin Toxicol (Phila). 2005;43(2):61‑87.
9. Persson HE, Sjöberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol. 1998;36(3):205‑13.
10. Tunwashe OL, Odukoya OO, Atiba JO. Acute poisoning in the emergency room in Lagos University Teaching Hospital. Trop Doct. oct 1985;15(4):164‑6.
11. Ouédraogo M, Ouédraogo M, Yéré S, Traoré S, Guissou IP. Acute intoxications in two university hospitals in Burkina Faso. Afr Health Sci. déc 2012;12(4):483‑6.
12. Kouéta F, Dao L, Yé D, Fayama Z, Sawadogo A. [Acute accidental poisoning in children: aspects of their epidemiology, aetiology, and outcome at the Charles de Gaulle Paediatric Hospital in Ouagadougou (Burkina Faso)]. Sante. 2009;19(2):55‑9.
13. Getie A, Belayneh YM. A Retrospective Study of Acute Poisoning Cases and Their Management at Emergency Department of Dessie Referral Hospital, Northeast Ethiopia. Drug Healthc Patient Saf. 2020;12:41‑8.
14. Waktola LG, Melese EB, Mesfin N, Altaye KD, Legese GL. Prevalence of unfavorable outcome in acute poisoning and associated factors at the University of Gondar comprehensive specialized hospital, Gondar, Northwest Ethiopia: a hospital-based cross-sectional study. Front Public Health. 2023;11:1160182.
15. Ajeigbe AK, Adedeji TA, Jeje OA, Olukoyejo OE, Bello MB, Ogra VO, Jokanola OJ, Ajose OA. Profile of Acute Poisoning among Adult Patients at the Emergency Room of a Tertiary Hospital, South-western Nigeria. West Afr J Med. 28 sept 2023;40(9):920‑4.
16. Areprekumor TE, Joboy-Okei E, Amadin NO, Kalu SU. Patterns and clinical outcomes of childhood poisoning presenting to a children’s emergency department in Yenagoa, Nigeria: a 10-year retrospective study. BMJ Paediatr Open. 15 mai 2024;8(1):e002433.
17. Pouokam GB, Lemnyuy Album W, Ndikontar AS, Sidatt MEH. A Pilot Study in Cameroon to Understand Safe Uses of Pesticides in Agriculture, Risk Factors for Farmers’ Exposure and Management of Accidental Cases. Toxics. 1 nov 2017;5(4):30.
18. Goga R, de Vasconcellos K, Singh D. Acute poisonings presenting to King Edward VIII hospital intensive care unit in Durban, South Africa. South Afr J Crit Care. 2021;37(1).
19. Baydin A, Yardan T, Aygun D, Doganay Z, Nargis C, Incealtin O. Retrospective evaluation of emergency service patients with poisoning: a 3-year study. Adv Ther. 2005;22(6):650‑8.
20. Zöhre E, Ayrık C, Bozkurt S, Köse A, Narcı H, Çevik İ, Toker İ, Demir F, Ovla D. Retrospective analysis of poisoning cases admitted to the emergency medicine. Arch Iran Med. févr 2015;18(2):117‑22.
21. Reed RP, Conradie FM. The epidemiology and clinical features of paraffin (kerosene) poisoning in rural African children. Ann Trop Paediatr. mars 1997;17(1):49‑55.
22. Lifshitz M, Sofer S, Gorodischer R. Hydrocarbon poisoning in children: a 5-year retrospective study. Wilderness Environ Med. 2003;14(2):78‑82.
23. Ngobese A, Govender S, Peer N, Sheik-Gafoor MH. Caustic ingestion in children treated at a tertiary centre in South Africa: can upper endoscopy be omitted in asymptomatic patients? Pediatr Surg Int. mars 2022;38(3):505‑12.
24. Boyle KL, Periyanayagam U, Babu KM, Rice BT, Bisanzo M. Pediatric Poisonings in a Rural Ugandan Emergency Department. Pediatr Emerg Care. mars 2020;36(3):e160‑2.
25. Ikhile I, Chijioke-Nwauche I, Orisakwe OE. Childhood Drug and Non-Drug Poisoning in Nigeria: An Economic Appraisal. Ann Glob Health. 9 juill 2019;85(1):100.
26. Orisakwe OE, Egenti L, Orish C. Childhood non-drug poisoning in Nnewi, Nigeria. Trop Doct. oct 2000;30(4):209‑11.