Profil des intoxications aigues de l'enfant en Cote d'Ivoire : etude multicentrique dans les 3 CHU d'Abidjan

摘要

Resume Les dernieres donnees disponibles sur les intoxications aigues chez l'enfant en Cote d'Ivoire datent de 1998. Nous avons donc initie une etude dans les trois CHU d'Abidjan de 2005 a 2011 portant sur 557 enfants ages de 0 a 15 ans afin d'etablir un profil plus actuel des intoxications, de leurs caracteristiques epidemiologiques et de leur prise en charge. Les intoxications representaient 8,50 % des admissions dans les services d'urgence et reanimation pediatrique et 70 % des victimes avaient moins de 5 ans. L'intoxication etait accidentelle dans plus de 95 % des cas. Les medicaments (26,45 %) etaient le plus frequemment incrimines, suivis des produits menagers (21,87 %) et des pesticides (14,82 %). Les anxiolytiques et les antipaludeens etaient impliques dans 48 % des intoxications d'origine medicamenteuse. La letalite liee a ces intoxications etait relativement elevee (5,75 %) et imputee a l'absorption de petrole (21,90 %), de decoctions de plantes (18,75 %) et d'antipaludeens (15,62 %). L'administration d'huile de palme par l'entourage de la victime (41 %) et l'evacuation vers des etablissements sanitaires Summary The most recent data on acute poisoning in children in the Ivory Coast were published in 1998. Consequently, we conducted a multicentre hospital-based study in Abidjan from 2005 to 2011 including 557 children to provide a most up-to-date and comprehensive picture of the situation. Poisoning represented about 8.50% of admissions to Emergency Room and Intensive Care, and 70% of victims were under 5 years old. Poisoning was unintentional in more than 95% of cases. Medication (26.45%) was the leading cause of acute poisoning, followed by household products (21.87%) and pesticides (14.82%). Anxiolytics and antimalarial drugs were involved in 48% cases of drug-related poisoning. Hospital fatality was relatively high (5.75%) and was mainly due to the absorption of petroleum (21.90%), plants (18.75%) and antimalarial drugs (15.62%). Administration of palm oil by relatives or community members as antidote (41%) and previous admission in an unqualified health centre (50%) delayed appropriate medical care by specialized paediatric units with life-threatening consequences for the child. Raising awareness of parents on chemicals hazards and safe storage conditions, a better knowledge of inappropriate interventions in case of poisoning along with the creation of a Poison Control Centre may reduce severe poisoning and improve acute poisoning management in paediatric emergency units.