A Retrospective Study of Poisoning at Muhimbili National Hospital in Dar-Es Salaam, Tanzania

Introduction: Poisoning is a public health challenge in low and middle income countries. Advances in technology and social development have led to an extensive use of medicines and chemical substances in these countries, hence increasing the prevalence of poisoning. Success in the management of a poisoning case depends on a number of factors including the availability of trained personnel, availability of support information and the understanding of local context. There is paucity of evidence from Tanzania showing the causes and management of reported cases of poisoning in healthcare facilities. Methodology: A retrospective cross-sectional study which was conducted at Muhimbili National Hospital, in Dar es Salaam. Data were collected by review of files of patient who were admitted due to poisoning for the past three years (2005-2008) and in-depth interviews with key informants using pre-tested semi-structured interview guides. Results: A total of 215 patients were admitted due to poisoning during the study period, 123 were males and 92 were females. Prevalence of poisoning was 3.28 cases per 1,000 hospitalizations. Majority of poisoning cases were observed in the age group between 16-40 years (>80%). Intentional poisoning by others was the most common pattern of poisoning (>36%). In more than 50% of the cases the poisoning substances had not been identified. Antibiotics and antiparasitics were the common medicines implicated in poisonings (17%). More than 90% of the poisoning victims recovered. Major fatalities occurred in the age group between 26-40 years at 58%. The mortality rate in men was higher giving a male to female ratio of 10:1. None of the healthcare personnel interviewed had received any specialized training on poisoning. Main sources of information mentioned included Drug Information reference formulary and senior colleagues. Increasing public awareness, availability of resources and organizational restructuring, and provision of specialized training are likely to have positive impact on poisoning management. Conclusion: Poisoning is one of the causes of hospital admission and mortalities at Muhimbili National Hospital. Effective management of poisoning cases is a multidisciplinary team approach which can be improved by several interventions such as establishment of poison information center, training of healthcare providers and ensuring easy access to anti-dotes. KeywordsPoisoning; Hospital Management; Poison Information Centre; Antidote