Accidental poisoning in children.

OBJECTIVE: To assess the pattern of acute poisoning in children at Liaquat National Hospital, Karachi. METHODS: The one-year descriptive study was conducted in the Paediatric Emergency Unit of the Liaquat National Hospital, Karachi, from April 1, 2006 to March 31, 2007, involving all patients under 12 years of age who visited the unit with a history of accidental exposure to toxic substances. Demographic data and all other relevant information were obtained mainly by retrieving hospital records and the admission register. Immediate outcomes were analysed in terms of admission, discharge and 'left against medical advice' (LAMA). RESULTS: During the study period, 43 cases of accidental poisoning were registered, constituting 0.58% of the total emergency visits. Most (46.5%) were less than 3 years of age. Pharmaceutical products (34.9%) were the leading cause of ingestion followed by kerosene oil (25.6%), organophosphorous (16.3%), alkali (9.3%) and acid (7%). Regarding the outcome of these cases, 29 were admitted, 7 were discharged and 7 patients left against medical advice. CONCLUSION: In our study, a small percentage of children presented with acute poisoning. Pharmacologic agents were a common source of poisoning in children. There is a need to further study and identify risk factors of acute poisoning in children.

Ethnic disparities in routine immunization coverage: a reason for persistent poliovirus circulation in Karachi, Pakistan?

Karachi is the only mega city in the world with persistent poliovirus transmission. We determined routine childhood immunization rates in Karachi and identified predictors of vaccine completion. A population-based cross-sectional survey was conducted in Karachi between August and September 2008. Data on demographics, socioeconomic, and DTP3 vaccination status in children 12 to 23 months old were collected. Logistic regression was used to identify predictors of vaccination completion. Overall, 1401 participants were approached; 1391 consented to participate. Of these, 1038 (75%) were completely vaccinated. Punjabi families had the highest DTP3 coverage (82%), followed by Urdu-speaking families (79%). Pashtun (67%) and Bengali (48%) families had the lowest vaccine coverage. Children of mothers with ≥ 12 years of schooling (OR = 25.4; 95% CI = 5.7-113.1) were most likely to be vaccinated. A quarter of study participants were unvaccinated. Targeted strategies for boosting DTP3 rates in communities with low immunization coverage are essential for polio eradication in Karachi.