Characterization of Emergency Department Poisoning Epidemiology in Belize

Abstract

Objective: Little is known about the epidemiology of poisonings in Belize. The purpose of this study was to characterize poisonings presenting to Karl Heusner Memorial Hospital, Department of Accident and Emergency in Belize City, Belize. Methods: Charts were reviewed for patients with possible toxicologic exposures, presenting between May 31, 2016 – December 31, 2018. Variables of interest included patient age and sex, type and route of poisoning, reason for exposure, and disposition. Results: Of the 60,310 patient visits during the study period, 768 patients, 1.3%, presented after a toxicologic exposure. The age distribution of poisoned patients varied with the largest proportion being between 19-30 years of age, 29.3%. There was a male predominance of patients, 60.4%. Approximately 44% of all poisonings involved ethanol only. Marijuana was the most common drug of abuse. Other common inhalation and ingested exposures included cleaning agents, household agents, acetaminophen, NSAIDs, pesticides, organophosphates, sedating medications, antibiotics, and ciguatera poisoning. Nearly 48 % of intoxication cases were due to intentional abuse, while about eight percent were from suicide attempts. Of identified poisoned patients, 84.4% were ultimately discharged, 13.8% were admitted, 1.6% were “self-discharged,” 0.13% were transferred, and 0.13% died. Conclusions: This study illustrates that poisoning is an important cause of Accident and Emergency visits in Belize, whose patterns may differ from those in other countries. Understanding the current state of poisonings in Belize can aid in the development of treatment protocols, antidote stocking, and educational activities for poisoning prevention.