Are you in danger of poisoning your child?

Are you in danger of poisoning your child?

A recent report indicates that accidental poisoning is on the rise in many homes and has led to disastrous consequences, including death, Carol Natukunda writes

You probably hid that paraffin bottle in the corner, hoping to lock it up later, but somehow, you got busy and forgot. The next thing you know your toddler is lying unconscious, having guzzled it all.

Accidental poisoning among children is on the rise in many homes, according to the latest research by the Uganda Paediatric Association.

The report exclusively obtained by Sunday Vision was carried out between 2011 and 2012.
It studied 108 children admitted with various types of poisoning at Mulago Hospital. Of these, 38% were female and 62% were male, aged between one month and 144 months (12 years). However, the age group most affected by poisoning was found to be one to five  years.

The study reveals that the poisons kept in the household were within reach of the children in 52.8% of the cases.

Such poisons ranged from paraffin, to rat poison, medicines and syrups, pesticides, alcohol and food poisoning. A 1-month-old was poisoned with tear gas. Some causes of poison could not be established. 

Of the poisons found within the household, 57% of the poisons were found either in the cupboard, which were left unlocked and 23% were on the floor.

There was reported intentional poisoning by malicious people in some of the cases.
The key investigators were project manager, Dr. Sabrina Kitaka and the project coordinator, Dr. Eric Wobudeya, both senior paediatricians at Mulago Hospital.

Who gives the child poison?
Most of these poisons (87.5%) were linked to housewives, seeing as they are the primary caregivers. But fathers, siblings and other relatives were also found to be responsible.

“Caregivers need to be absolutely cautious about where they keep medicines and all sorts of drugs that are harmful. It is critical for parents to close their drug cupboard and strictly keep all drugs away from children,” Kitaka told Sunday Vision.

Most of the poisoning in the home happened in the morning hours between 8:00am and 12:00noon, when the caregiver is probably busy with chores. But poison was not just consumed at home. It was noted that some children took poison in the neighbours’ homes and the compound, while for a large number of children, it was not clear where the children got the poison from.

Commenting on this, psychologists say children explore their environment as part of their natural development. “They learn about new things by playing with them, trying to open containers, mimicking what they see adults do, like drinking from the beer bottle you leave on the table, putting things in their mouth and so on,” explains Prudence Atukunda, a clinical psychologist at Butabika Mental Hospital.

Atukunda says a child is exposed to poison without knowing that it may be harmful. “Children do not know the difference between what is safe and what is dangerous. Parents and caregivers must take responsibility for making the home safe for children,” she explained.

 Most poisonings involving children happen at home, but they can also occur while visiting friends and family or while on holiday, Atukunda notes.

“Often, the substance is left within sight, ready to be used, but left unattended. At other times, children may climb up high to get something they are interested in. Sometimes, parents and caregivers underestimate their child’s climbing ability,” she   explained.

The most common poisoning was paraffin (32%) followed by herbicides/pesticides poisoning (30%), and medicines.
Commenting on this, Kitaka explained that a child may also be poisoned if they are given the wrong medicine or wrong dose of medicine.

“Some children get poisoned with tablets in paper envelopes, they pick it and swallow them; some caregivers unknowingly do not follow the recommended dose. Poisoning can occur if the recommended dose exceeds the kilogramme per body  weight.”

On paraffin and pesticides, the study revealed that most of these poisons were in beverage bottles, which children probably mistook to be ordinary drinks.

In fact, while paraffin was found to be the number one cause of poison, the report showed that there was little chance that it was got from a lamp. Only 1.9% of the poisoning was from the lamps, compared to 32.4% from a beverage                        bottle.


Signs of poisoning
Diarrhoea and vomiting were reported in all cases. The commonest first aid given to the children was milk. The report is silent on whether this worked.

However, loss of consciousness was reported in almost half of the cases. 92% of the cases were admitted to a medical facility for at least a day.

Dangers of poisoning
During the study period, there were two deaths reported, which represented a 1.8% mortality rate. Globally, it is estimated that over 16, 000 children under 14 years die annually from poison-related  diseases.

Things to remember
The main age group affected by poisoning is one to five years
The major form of poisoning is paraffin poisoning
Most of the children obtained the poisons from beverage containers
Most of the poisons were within the house and within reach of children Most of the poisoning occurred in the morning hours, between 8:00am and 12:00noon
The majority of primary caregivers were housewives

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Way forward
The report calls for wide sensitisation of health workers, parents, schools and families on how to handle childhood poisoning. In the mean time, the surveillance team has developed a management chart for the common poisons encountered in Uganda, which have been presented to the health workers for action.

Posters raising awareness on childhood poisoning have been made and pinned up at child health service centres, while schools are being encouraged to hold contests and debates on the topic.

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CHILDREN’S health
Is your child safe from lead poisoning?
Often, people think of food, drugs and chemicals when poison is mentioned.

However, some metals are as bad as any drug and chemical you can think of, for they leave lasting effects on their victims. Lead, for instance, poisons the blood and leads to developmental and intellectual impairment.

According to a 2009 research to determine the effect of early lead exposure on the academic performance and behaviour of school going children, there is a link between a child’s poor score in reading, writing, spelling and anti-social behaviour.Such children, the 2009 study found, are negatively affected by early lead exposure that exceeds certain levels.

Another research established that children with lead levels below 10 micrograms in their blood are in danger because it impairs brain development and negatively impacts their academic performance.

With this in mind, consider another study that was done on school going children living near Kiteezi landfill in Kampala.

It was carried out by researchers led by Leonardo Trasande, an assistant professor of preventive medicine and paediatrics and assistant director, Center for Children’s Health and the Environment, Mount Sinai School of Medicine, New York.

Results showed that some of the children had dangerously high lead levels in their blood, thanks to the presence of lead and other metals in their home area.

The researchers studied 163 children between four and eight years of age, all going to nine different schools near the landfill. They examined their blood and soil samples within a 1.5 mile distance between the landfill and their homes and school. The children also answered questionnaires

. Results published in the Environmental Health Perspectives showed that 20.5% of these children had dangerously high blood lead levels (elevated blood lead levels) that exceeded 10 micrograms.

In addition, children whose homes were half a mile from the Kiteezi landfill were found to have a higher chance of having elevated blood lead levels.

Trasande noted that the occurrence of lead in the area pointed to poor waste management, something that has to be handled more effectively in order to reduce lead poisoning in children.

So next time you think of poisoning, think beyond food, drugs and chemicals, for sometimes the danger lies in the least considered sources in your environment.

Trasande’s research showed that the families living near Kiteezi that collected water from dug wells were less likely to get lead poisoning.

Likewise, the consumption of canned foods exposed the consumers to more risk probably because of the presence of lead solder in cans. 

Compiled by Elizabeth Namazzi

 
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ASK THE EXPERT

Q What first aid can one do if you realise your child has taken poison?

A Before you even talk about first aid, it is always good to have a phone number of at least two family doctors to contact in case of emergencies, so they advise you on what to do, even if it is over the phone. Of course, you do this as you rush to hospital. Different poisons are handled differently.
 
Does milk work?
On the whole, the common first aid antidote for swallowing a heavy poison is to drink milk. The poison then acts on the protein of the milk rather than on the protein sites and tissues of the mouth, esophagus and stomach.

Vomiting can be induced to expel the poison that has combined with the milk.

Before the seizures or unconsciousness, what other signs can one look out for, before it is too late?
If you find your child with an open or empty container of a suspicious substance, your child may have been poisoned.

A child might have redness around the mouth and lips, breath that smells like chemicals, stains/drops of the poison on the clothes or in the house. Other symptoms are vomiting, difficulty breathing, sleepiness or other strange behaviour.

How can one prevent poisoning among children?
The best protection is to make sure that children do not have access to any poisons or medicines.

Ask other people who care for your child, such as your daycare centre, to do the same. Store all medicines, cleaning or gardening sprays and household chemicals out of children’s reach, preferably in a locked cabinet.

Avoid distractions when administering medicines and follow the dosing instructions on the label or by your                     doctor.
 
Dr. Alfred Driwale, district medical officer, Koboko district