Original Research Article http://doi.org/10.18231/j.jchm.2019.003 The Journal of Community Health Management, January-March, 2019;6(1):12-20 12 Children drug poisoning in Jeddah: Prevalence, pattern and mother’s practice Sahar Fareed Al-ahdal 1,* , Rajaa Al-Raddadi 2 , Hadeel Khaled Akbar 3 1 Consltant, 2 HOD, 3 Trainer, 1 The Joint Program of Postgraduate Fellowship in Family Medicine, Jeddah, Saudi Arabia, 2 King Abdulaziz University, Jeddah, Saudi Arabia, 3 Prince Nora Oncology Center, King Abdulaziz Medical City, Jeddah, Saudi Arabia *Corresponding Author: Sahar Fareed Al-ahdal Email: saharna2015@gmail.com Abstract Introduction: Accidental children poisoning is a potential source of morbidity and mortality. There is a paucity of data about its burden in Saudi Arabia. Objectives: To assess the prevalence and patterns of acute poisoning in children and the response of mothers/caregivers to its incidence in Jeddah, Saudi Arabia. Materials and Methods: A cross-sectional study was conducted including the mothers who attended the primary healthcare centers (PHCs) during the period from Sep to Oct 2017 Seven PHCs were randomly selected followed by selecting a proportional sample of mothers from each center. Data collection was performed through an interview with the participants via a structured questionnaire. Results: In a total of 354 mothers (69.8% with at least a high school education), 82 mothers (23.2%) reported a history of poisoning. The affected children aged 2-5 years with a slight male propensity (53.7%). Therapeutic drugs accounted for 87.8% of cases (mainly antipyretics, cough syrups and decongestants). Telephone consultation and immediate referral to the nearest PHC were the most common responses (86.1% and 70.8%, respectively). Family members were the most frequent source of information (69%) while 76.4% of the mothers had no contact with the drug poisoning center. Poisoning episodes increased significantly when the mother was less educated (P =0.017), non-working (P=0.026), had another child aged <1 year (P=0.029), or transferred to a new home (P=0.033). Conclusion: Accidental children poisoning represents a significant burden. Effective communication with the local drug poisoning center should be established. There is an urgent need to conduct aggressive campaigns to reduce poisoning rates. Keywords: Poisoning, Children, Saudi Arabia, Morbidity, Drug-related side effects and adverse reactions. Introduction Despite the implementation of several strategies to reduce accidental drug poisoning, toxic exposure implies a considerable burden on the community and healthcare resources. Poisoning is referred to as an exposure to a substance that can cause unfavorable consequences and signs of organ dysfunction leading to injury or mortality. Drug poisoning was the leading cause of injury-related deaths in the United States, accounting for up to 44,000 death in 2015, 1 while non-fatal episodes comprised approximately 22%-54% of hospital admissions in Saudi Arabia. 2-4 According to the most recent Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS), 5 drugs were associated with poisoning episodes in 57% of total poisoning cases in 2017. In children, acute poisoning is even more prominent. Pediatric drug poisoning is mostly accidental due to their decreased ability to control themselves than older individuals and their reduced perception of harmful substances and hazardous materials. Therefore, they are particularly vulnerable to accidental poisoning. The extensive availability of medications, household chemicals, and pesticides has a major impact on increasing the rates of accidental poisoning in children. However, there is a strong evidence showing that fatal childhood poisoning incidents have decreased dramatically since the early 1970s following the introduction of the children resistant containers (CRC) to the markets although the frequency of such episodes remains an important public health concern. 6 This decreasing trend may be also attributable to establishing poison control centers in the developed countries, early recognition of exposure, and the significant improvements that occurred in poisoning management. 7 Data from National Center for Injury Prevention and Control, Centers for Disease Control and Prevention showed that about 41,000 non-fatal unintentional drug poisoning emergency visits were reported in the United States in 2017 among children aged less than 4 years, representing 2.3% of all injuries in this age group. 8 Considering Saudi Arabia, a cross-sectional study of patients attending the emergency department in King Khalid National Guard hospital revealed that children under 12 years represented 44.2% of total visits, of which drug poisoning was reported in the majority of them (92.2%). 9 In other countries, there are comparable estimates of children drug poisoning, with remarkable elevations in low- and middle-income countries. 10 Lack of parental awareness, inadequate public knowledge, and the absence of poison control centers may all contribute to increased poisoning- related morbidity and mortality. Awareness of family members, including the mother, regarding the potential risk factors is an important element to prevent acute poisoning. Moreover, although acute poisoning is manageable and rarely leads to death, the burden has a significant impact on the physical and mental health of the families. The emotional consequences and familial anxiety are remarkable and should be considered. 11 From another perspective, medical treatment of childhood poisoning is costly. In 2013, the total expenditure of unintentional poisoning in the United States was estimated at US$3.79 billion with a total of US$50,255 spent per case. 12 In Saudi Arabia, a recent cost analysis indicated that drug poisoning costs US$1.94 billion, accounting for 1.6% of total