Situation of Common Poisoning in Bangladesh Dr Md Robed Amin
Associate Professor of Medicine Dhaka Medical College
05.12.2014
Slide 2
Poisoning >600,000 deaths/year in developing world,
(Eddleston, Q J Med 2000) DMC- 2 nd cause of admission(After
stroke), More than 5000 case per annum since 2008. 2 nd common
cause of hospitalization and 9 th common cause of death(DGHS-Health
bulletin-2011)
Slide 3
Prevalence of top 10 diseases/causes of admission In UHC (DGHS
health Bulletin 2014 p49-55) Male (n 762264) Female (n 894425)
SerialDiseaseTotal%DiseaseTotal% 1 3 3 4 5 6 7 8
SerialDiseaseNumber%DiseaseNumber%
1Diarrhoea14474218,99Diarrhoea14215715.89
2Assault12589516.52Assault9919611.09 3Peptic ulcer523926.87Peptic
ulcer618626.92 4Pneumonia521056.84Pneumonia345673.86
5Enteric267533.51Enteric261082.92 6RTA264553.47Obstructive labour
228972.56 7Bronchial Asthma 234463.08Bronchial Asthma 214992.40
8Viral19 1882.52Anaemia208482.33
9Poisoning186972.45Poisoning196402.20 10HTN103741.36Viral
fever184412.11
Slide 4
Top 10 diseases/causes of admission in upazila health complexes
in 2012 and 2013 (DGHS health Bulletin 2014 p49-55) 2013 2012
Percentage trends DiseaseRanking% %Ranking change
Diarrhoea116.32117.74 Assault213.59213.51 Peptic ulcer36.9036,43
Pneumonia45.2346.41 Enteric53.1953.48 Bronchial Asthma 62.7162.51
RTA72.3972.40 Poisoning82.3192.23+1 Viral92.3182.24
Anemia101.79101.56
Slide 5
Prevalence of top diseases/causes of admission In District
Hospital Male Female SerialDiseaseTotal%DiseaseTotal% 1 3 3 4 5 6 7
8 SerialDiseaseNumber%DiseaseNumber%
1Diarrhoea5895213.53Diarrhoea5319811.79
2Assault392269.00Assault238995.30 3RTA240845.53Peptic
ulcer159943.54 4Pneumonia208194.78Pneumonia140743.12 5Peptic
ulcer1418823.26Obstructive labour 115712.56 6Bronchial asthma
123502.83Bronchial Asthma 111402.47 7viral115592.65HTN106872.37
8Poisoning90592.08RTA103972.30 9HTN84511.94Viral99232.20
10CVD81861.88Anxiety/de pression 94412.09
11MI80211.84Poisoning93382.07
Slide 6
Prevalence of top diseases/causes of admission In Primary,
secondary and tertiary care Male Female
SerialDiseaseTotal%DiseaseTotal% 1 3 3 4 5 6 7 8
SerialDiseaseNumber%DiseaseNumber%
1Diarrhoea21159114.47Diarrhoea20182712.94
2Assault18349812.55Assault1319878.46 3Pneumonia792615.42Peptic
ulcer811575.20 4RTA707254.84Pneumonia537753.45 5Peptic
ulcer706424.83Obstructive labour 382902.45 6Bronchial asthma
409012.80Bronchial Asthma 368822.26 7Enteric fever370562.53Enteric
fever 347752.23 8Viral fever326772.24Poisoning331052.12
9Poisoning310142.12RTA326822.10 10HTN233071.59Anemia326752.09
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Slide 9
Mortality report of DGHS (ICD based) in 451 public hospital
Name of disease Number Percentage Diseases of the circulatory
system 1620633.20 Certain conditions originating in the perinatal
period 777915.93 Diseases of the respiratory system 678713.90
Injury, poisoning, and certain other consequences of external
causes 45219.26
Slide 10
Baseline Survey Baseline survey: 6 months from Sep 2006 - Feb
2007 in 4 hospitals and 7 health centres: (Prof MA Faiz) 4553 cases
(28% pesticide) 14.5% of admissions Mortality 4.1% (88%
pesticide)
Slide 11
Place PesticideSedatives Kerosi ne Snake bite Cu-Sul phate
Methan ol Potka fishOthers Total OP Car mate Others Benzod iazepin
e Other sedativ e DMCH 27923276018977310251212982318 CMCH
299781119343830313005051390 Coxsbaz ar 9004417000013119 Hathaza ri
UHC 26013511600074126 Jenaida4453681713114039537 Sitakun d UHC
290420712010863 Total 11683312373795413943472019374553
Slide 12
Gender of patients Name of poison/toxic substance
PesticideSedativeSnake bite Kerose ne Cu Sul- phate Metha nol
OPCarba mate OthersBenzo diazepi ne Other Male6661656391826315 6.9%
86416 15.6%26.5% Female5021767346128119 2.6% 5334 12.7%10.3% Total
1291 28.3% 1675 36.8% 434 9.5% 139 3.0% 720 0.4%
Slide 13
Survey in Dhaka Medical College Hospital (DMCH) 2008 5932 total
cases of poisoning in DMCH 2108/5929 (35%) female; 3821/5929 (65%)
male Median age was 25 years (IQR 19-35 years) Overall mortality
was 151/5932 (2.6%)
Slide 14
DMC survey 95% sought initial - Government Hospital. Suicidal
attempt -43.8% Family disharmony -37.7% stupifying agent (38.2%).
Mortality: 105 OP death among 151 herbal medicine-25%, then OP
poisoning- 16%., methanol poisoning-11% and copper sulfate
poisoning (9%).
Slide 15
Major risk factor for mortality rural residence, hindu
religion, illiterate, farmer, suicide attempt, deliberate self
harm, GCS 100/