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060			_aWA 240
100			_aGyenwali, Deepak _93861
110			_aNepal Public Health Foundation (NPHF) _93862
245			_aA report on epidemiological study on pesticide poisioning cases in Chitwan
300			_ax, 34p.
520			_aSummary: Hundreds of chemical compounds are used to manage agricultural pests/domestic pests and to control the vectors of public health importance. Despite the associated benefits of pesticide use, there have been concerns on adverse effects of these chemicals in human health. Pesticide exposure has significant negative impacts on human health including acute severe poisoning leading to death and many chronic health effects. The cases of acute poisoning, including suicide attempts, mass poisoning from contaminated food, chemical accidents in industry, unintentional accidents and occupational exposure in agriculture, constitute the most serious health hazard associated with pesticides use. Acute pesticide poisoning is a major cause of emergency department visit in hospitals. However, there lacks enough information of pesticide poisoning in Nepal. The overall objective of the study was to evaluate the epidemiological characteristicts of the pesticide poisoning cases in hospitals in Chitwan district. A hospital based, quantitative , descriptive study was carried out in four major hospitals of Chitwan district vz. Bharatpur Hospital, CMC teaching Hospital, CMS teaching hospital and Ratna Nagar hospital. Perticide exposure record (PER) form which was used for the data collection. _bAll the pesticide poisoning cases attending the hospitals during April1 to December 31, 2015 were included in the study. The information was recorded by interviewing the patient or patient's visitor and reviewing the hospital records. Database was prepared in SPSS software and analysis was mostly descriptive. A total of 439 acute pesticde poisoning cases from 12 districts including Chitwan and adjecent districts attended the hospitals in Chitwan. Most of the cases attended Bharatpur hospital, a government hospital. The incidence rate for Chitwan district is 4.70 per 10000 population for the study period. The incidence rate was higher among the females than among the males. The proportion of acute pesticide poisoning was higher among the young adult age group (between the age 15 and 29 years; the median age of the cases was 26 years), among female (66.5%), among rural residents (71.3%) and among disadvantaged janajatis (37.8%) and upper caste ethinc groups (35.8%). Most of case got poisoned during evening hours (43.7%) at their home (99.1%). Nearly 90% of the cases used pesticides intentionally for self harm/suicides, about 9.0% got poisoned accidently and very few got poisoned by occupational exposure to pesticides. The pesticide used was mostly in liquid form (75.9%); higher proportions were insecticides (59.9%) and rodenticides (20.8%); chemical compounds were organophosphates (39.6%), pyrethroids (35.1%) and phosphides (21.6%). The median duration of time elapsed since exposure to hospital consultation was 2.0 hours. Of the cases consulted to hospital, 97.0% were hospitalized and 2.3 % were referred to other hospitals. Among the hospitalized cases 93.4% developed systemic effects, nearly 30.0% were in severe condition while attending hospitals and 41.3% were provided with ICU care. The median duration of hospital stay was 4 days with a range from 1-24 days. Of the hospitalized cases,87.3% recovered and 4% succumbed to death. This study provided the information of situation of pesticide poisoning in a district. As there is no registration and reporting system of poisoning cases in the current HMIS, the information can be a trigger to include poisoning in the information system. Finding of this study can be the basis for establishing drug and poisoning information centre in the country. The study recommends a public health program for preventive measures to reduce the access of general public to pesticides and a parallel mental health program to address psychological problems to prevent suicides. Further study is warrented to explore the reason of pesticides being the method of choice for suicide.
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