Abstract
Introduction: Organophosphate pesticides are widely used worldwide, and poisoning from these substances is a public health concern, especially in developing countries. The neurotransmitter acetylcholine builds up, and acetylcholine receptors in the central and peripheral neurological systems are continuously stimulated by the inhibition of acetylcholinesterase, which is the mechanism of toxicity. Organophosphates can cause several subacute or chronic neurological disorders in addition to acute cholinergic crises. One of the most frequent causes of poisoning in children is organophosphate (OP) poisoning.
Methodology: A retrospective review of hospital medical records of all children aged from 1 to 12 years who were admitted to the PICU and medical units with the provisional diagnosis of organophosphate poison at Nelson Mandela Children's Hospital and Charlotte Maxeke Hospital between January 1, 2018, and December 2024 was conducted. Patients with incomplete medical record information were excluded from the study.
Results: The study found that 63.9% of affected children were boys, with the majority (73.6%) being under the age of six. Organophosphate poisoning was most prevalent among this group. Geographically, most admitted cases were from Johannesburg North (41.3%), with a significant proportion (84.6%) coming from unemployed families. A total of 63 patients required ICU admission, with 98.4% arriving within 2–3 hours. Notably, ICU admission rates were higher among children from unemployed families (84.1%, n=53). Factors influencing discharge showed a negative correlation between clinical manifestation severity and discharge likelihood, meaning that as clinical severity increased, the chances of discharge decreased. Additionally, the odds of being discharged due to the mode of treatment were 3.372 times higher than remaining hospitalized, with a 95% confidence interval of 1.807 to 6.291. Regarding mortality, the most common clinical manifestations were salivation, drowsiness, and vomiting. However, these variables did not significantly predict mortality, as indicated by the statistical analysis (F (3,204) = 0.139, p > 0.001).
Conclusion: Late arrival to the hospital increases the chances of being admitted to the ICU. Proper usage of pesticides and proper storage of food and water are essential for minimising
exposure to organophosphate poisoning.