Intoxicaciones Pdf Colombia

Conclusions:It should be noted, the preventive natures of poisonings, given that 40.5% are suicidal concept, followed by intoxications for addiction that represent 26.6% of cases, these represent 67.1% of all cases. In addition, the levels of primary and secondary schooling present a significant association with the outcome regarding individuals without schooling. However, the only protective factor with significant association is age.Keywords:Poisoning; epidemiology; Colombia; drug overdose; suicide, attempted.

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Paraquat (PQ) poisoning is a major health problem worldwide, mainly due to self-poisoning related with suicides or by occupational exposure ,. Globally, 250,000 to 370,000 people die from pesticide poisoning each year, and more than 90% of the individuals with acute poisoning attempted to commit suicide by intentionally ingesting PQ. Most deaths occur in Southeast Asia, Central and South America.

The marketing of PQ has been banned in 32 countries; but it low-cost and unrestricted availability promotes its extensive use mainly in rural areas in developing countries ,. According to the National Institute of Health in Colombia, pesticides resulted in 1231 deaths in the period between 2008 and 2015, with a worrying positive trend accentuated in northeast of this country ,. Paradoxically, the global burden of disease in Colombia never has been determined, in consequence, the mortality or the disability induced by acute PQ intoxications is underestimated and minimized compared with its economic impact on benefit to agricultural production. Then, the lack of pharmacoeconomic indicators preclude the promotion of a better regulatory legislation that prioritize first the risk on the human health over any apparent economic or social benefit ,. In 1990’s, the Global Burden of Disease study quantified the health effects of morbidity and mortality attributable to more than 100 diseases around the world.

Since that time, a new more-complex metric was used different than traditional estimates of incidence, prevalence and mortality. These new indicators allow to determine the real burden of the disease by measuring both years of life lost as well as premature death and disability. While the burden of pesticides poisoning has been studied widely, commonly these reports do not differentiate the type of chemical involved in the poisoning.

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Without any doubt, the disability and lethality of the PQ poisoning is the higher although lesser frequent compared with any of the other pesticides intoxications, then pharmacoeconomic studies in this area are limited and potentially biased. A valid and consistent description of burden of disease is a great input to generate better health-policies and planning processes. Here, the aim was to estimate the disease burden of PQ poisoning in the Department of Antioquia (Colombia) between 2010 to 2016. To estimate the PQ burden of disease we use hospital admissions and mortality rates from comprehensive data for Department of Antioquia. This department is the second department with the highest population of the country (around 6,613,118 inhabitants).All records of patients intoxicated by PQ during the 2010–2016 in the department of Antioquia to the national epidemiological surveillance system (SIVIGILA) were analyzed.

In SIVIGILA, all patients intoxicated by chemical substances are reported online or in paper form to the SIVIGILA by each hospitals; being this report obligatory and made by personnel trained. The information recorded is age, sex, ingestion at hospital admission, amount ingested, symptoms, ethnicity, and type of exposure and mortality.No personally identifiable information was recorded all information obtained from health surveillance systems were kept confidential. Consent was not required because this was a study that used secondary sources of information already published. This study was approved by the Institutional Review Board of University of Antioquia (2015–4690).The mortality data were in turn contrasted with that reported by the National Department of Statistics - DANE for the department in the period studied. We calculated the DALY for acute poisoning using methods described by Murray and Lopez in the GBD study ; which summed the YLL and YLD components. The basic formula is expressed as follows: DALY = YLL + YLD.

Sultans of swing rapidshare. We estimated YLL by multiplying the number of PQ poisoning deaths by the number of years of expected remaining life at the respective age of death according to reference life tables of the global burden of disease study. For all estimates were used the population structure of the department of Antioquia in 2013 (half of the study period). In total, 154 patients with diagnosis of PQ poisoning were reported from department of Antioquia, between: 2010 to 2016.to the national epidemiological surveillance system (SIVIGILA). The majorities were mestizos and white, farmworkers, most of them between 20 and 29 years, coming of Uraba, with intentional exposure per oral route.

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The incidence rate was 2.37 per 100,000 inhabitants (CI 95%: 2.14–2.95 per 100,000 patients). Highest incidence rates were seen males (2.78 per 100,000 inhabitants), farmworkers, between 30 to 39 years old, respect to females (1.96 per 100,000 inhabitants) or males of other age groups. 14 deaths were registered to the national epidemiological surveillance system. Highest mortality was seen in males, between 30 to 39 years old, with intentional ingestion of PQ, see Table. The burden of disease in the northeast of Colombia by PQ poisoning was around 53.4 years of life adjusted for disability per 100,000 inhabitants.

In our knowledge, this is the first estimate in terms of burden of the disease specifically for this product. Previous studies have estimated only DALYs for poisoning in general and not by each chemical substance. For example, global burden study estimated that all poisonings account around 3,149,000 DALYs, and in Colombia: 6021 DALYs (12.41 DALYs per 100,000 inhabitants). In relative terms, all poisoning generate only 0.059% of the total number of DALYs in our country; behind the violence, traffic accident, and self-injurious injuries (8.85, 3.53 and 1.6% of the country’s total DALYS, respectively). These estimations contrast with our results, where the rate of DALYS per PQ is four times higher than all poisonings (53.4 per 100,000 inhabitants’ vs 12.41 DALYs per 100,000 inhabitants).

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These differences may be due to different sources of information used in the first place; while global burden of disease, used data from national health survey to estimate the incidence and mortality data; our source was directly the records of epidemiological surveillance for incidence. The great advantage of using the records of epidemiological surveillance is that they have a greater degree of completeness and less probability of information biases since they are mandatory records in our country and completed directly by the doctors who treats the poisoning; and not a survey which may be subject to information bias due to its retrospective nature. In this regard, similar behavior is also observed when comparing the rates of DALYs between the global burden of disease study and the study of burden of the disease in Colombia in 2010.

National study used SIVIGILA data -as in ours study- and rates are obtained in some cases also higher than reported by the global burden of disease study. For example, the global burden study of the disease estimates a total of 21,191 DALYs per 100,000 for Colombia; while the Colombian study of burden of disease 2015 estimates a higher total value of around 26,900 DALYs per 100,000; this behavior is accentuated especially in injuries generated from external causes where the most used sources corresponded to SIVIGILA. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. Authors and Affiliations.