Document Type: Original Article


1 Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh

2 Neurology Department, Dhaka Medical College, Dhaka, Bangladesh

3 Dhaka Medical College, Dhaka, Bangladesh

4 Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, UK


 Objective: The scale of the problem of poisoning is enormous hence clinico epidemiological spectrum of all poisoning cases need to explore to generate the management tool.

Methods: This prospective study was done at two medicine units (Unit 5 and 10) of Dhaka Medical College Hospital from July to December 2010 where all poisoning cases were seen. A total of 2890 patients were admitted out of which 600 were taken into the study.

Results: Among the poisoning cases 29% were pesticide, 27% travel related poisoning, and 20% benzodiazepine. 70% of poisoning occurred below 30 years of age and male: female ratio was 3:2. Incidence of poisoning was highest among students (31%) and housewives (25%). Majority of the patients were from urban area (76%) and most common intention was suicidal (66%). Familial disharmony was the prime cause (63%) behind poisoning. 42% cases got admitted between 5-8 hours of poisoning and more than 80% patients were admitted in the hospital directly without getting any first aid anywhere. Sixty-eight percent had Glasgow coma scale (GCS) score above 10 during admission. Cardinal clinical features of poisoning were nausea/vomiting (63%), drowsiness (56%), miosis (31%). Seventy percent patients were treated with only general and supportive treatment and specific antidotes were used in 30% cases. Case fatality for pesticide, benzodiazepine/anti-psychotic, rodenticide and snake bite was 6.9%, 2.2%, 8.3% and 3.3% respectively.

Conclusion: To assess the magnitude of problem, awareness of the public for prevention, immediate first aid measures and quick hospital admission is crucial component of poisoning.


Main Subjects

1. Gupta SK, Peshin SS, Srivastava A, Kaleekal T, Pandian TV. An epidemiological pattern of poisoning in India. Pharmacoepidemiol Drug Saf 2002; 11(1): 73-4. doi:10.1002/pds.672.

2. Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R , et al. The global burden of snakebite: a literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med 2008; 5(11): e218. doi: 10.1371/journal.pmed.0050218.

3. Thomas SH, White J. Poisoning. In: Nicki RC, Brian RW, Stuart HR, eds. Davidson’s Principles and Practice of Medicine. 21st ed. Edinburgh: Churchill Livingstone; 2010. p. 204.

4. Bangladesh Health Bulletin, MIS, DGHS; 2010. p. 55-67.

5. Badri MA. A program to establish a poison information center in Bangladesh (yet to be published). 2004.

6. Majumder MM, Basher A, Faiz MA, Kuch U, Pogoda W, Kauert GF, et al. Criminal poisoning of commuters in Bangladesh: Prospective and retrospective study.

Forensic Sci Int 2008; 180(1): 10-6. doi: 10.1016/j.forsciint.2008.06.016.

7. Alam J. 700,000 suffer snake bites in Bangladesh every year. The Scotsman. 2009 Aug 10.

8. Ahmed R, Shah R, Amin MM, Parveen S, Dey DK. Pattern and mortality rate of poisoning in Dhaka Medical College hospital. J Medical Teachers Federation 1995; 1(1): 10-12.

9. Khan NI, Sen N, Haque NA. Poisoning in a medical unit of Dhaka Medical College Hospital in 1983. Ban Med J 1985; 17(1): 9-12.

10. Rahman MH, Salad MA. An epidemiological study on acute poisoning in a rural hospital of Bangladesh. JOPSOM 2000; 19(1): 40-6.

11. Year book of the department of Medicine. Chittagong Medical College Hospital, Chittagong, Bangladesh; 2002.

12. Faiz MA, Hasan M. Situation of poisoning in Bangladesh, Country report in SAARC meeting on poisoning. Colombo 1999; 1: 31-32.

13. Amin MR, Mamun SH, Ali M, Rahman M, Hasan AA, Rahman MR, et al. Poisoning while traveling (transport poisoning): is it a new entity? The Internet Journal of Tropical Medicine 2008; 5(1): 1-6.

14. Azhar MA. Poisoning cases in a district hospital of Bangladesh. JOPSOM 1992; 11(2): 69-72.

15. Faiz MA, Rahman MR, Ahmed T. Management of acute poisoning with organophosphorus insecticides. J Ban Coll Phy Sur. 1994; 12: 59-62.

16. Karki P, Hansdak SG, Bhandari S, Shukla A, Koirala S. A clinicoepidemiological study of OPP at a rural based teaching hospital in eastern Nepal. Trop Doct 2001; 31(1): 32-4.

17. Howlader MA, Sardar MH, Amin MR, Morshed MG, Islam MS, Uddin MZ, et al. Clinico-epidemiological pattern of Poisoning in a tertiary level hospital. J Dhaka Med Coll 2008; 17(2): 111-5. doi: 10.1016/j.forsciint.2008.06.016.

18. Eddleston M. Pattern and problems of deliberate self poisoning in developing world. Q J Med 2000; 93(11): 715-31. doi: 10.3329/jdmc.v17i2.6593.

19. Maracek J. Culture gender and suicidal behavior in Srilanka. Suicide Life Threatening Behav 1998; 28(1): 69-81.

20. Linden CH, Burn MJ. Poisoning and drug over dosage. In: Braunwald E, Fauci AS, Kasper DL, eds. Harrison’s Principles of Internal Medicine. 17th ed. New York:

McGraw-Hill; 2008. p. e281.

21. Prince BS, Goetz CM, Rihn TL, Olsky M. Drug-related emergency department visits and hospital admissions. Am J Hosp Pharm 1992; 49(7): 1696-700.

22. Sarker ZM, Khan RK, Acute Poisoning – Scenario at a district hospital. Bangladesh J Med 2002; 13: 49-52.

23. Batra AK, Keoliya AN, Jadhav GU. Poisoning: an unnatural cause of morbidity and mortality in rural India. J Assoc Physician India 2003; 51: 955-9