Paracetamol Self-poisoning Epidemiology of Selected Districts of Sri Lanka

Abstract

OBJECTIVE: Paracetamol admissions in Sri Lanka have been increasing in urban hospitals. Official government statistics of 5ri Lanka does not recognize paracetamol as a separate entity but is listed under poisoning by drugs, medicaments and biological substances. Epidemiology of paracetamol poisoning in rural areas is important to allocate resources and develop public health policy.The objectives of this study was to describe epidemiology of paracetamol poisoning. METHODS: A prospective study was carried out using the cohort data base maintained by SACTRC. Data of 5 tertiary care hospitals (peradeniya, Kurunegala, Matara, Galle and Anuradhapura) were used to describe epidemiology of paracetamol poisoning. Three districts (Anuradhapura, Matara and Galle) were used to calculate prevalence of paracetamol poisoning. The government census data of 2012 was taken to calculate incidence. RESUTTS: There were 27,ggg patients admitted to 5 tertiary care units during study period.6,2g1 (23o/o) of these were due to paracetamol poisoning. There were 4,1 g1 (670/o) females and 2,100 (33o70; males. Majority of the admissions were due to ingestions between l6_20 tablets while 1l_ 25 tablet range is the most frequently overdosed range of paracetamol tablets. The median age of the cohort was 19 (lQR-l7-24). Significantly higher number of patients ingested less than 20 tablets (non_toxic) (p<0.0001). The number of male patients who ingested toxic amounts (more than 21 tablets)was significantly higher than females (p<0.0001). Annual population incidence in females was higher than in males (42 versus 23 per 1OO,0O0 population /per year, respectivery). Anarysis of data of three districts, (Kurunegala, Matara and Galle) revealed that the overall age and sex adjusted annual district incidence were 64 (Cl 60_ 68), 5t (Cl 46-57) and 68(Ct 63-74) per 100,000 population/ per year respectively. .ONCLUStoN: Paracetamol poisoning accounts for 23o/o of all poisonings in the four year study period based on the results of the tertiary care hospital data.