A HIGH CASE FATALITY REPORT OF ALUMINUM PHOSPHIDE POISONING: A CASE SERIES FROM AABET HOSPITAL
Aluminum phosphide is a fumigant pesticide produced in tablet form. Aluminum phosphide releases phosphine (ph3) gas, which primarily affects cellular respiration by blocking cytochrome oxidation in the mitochondria. In a two-month case series collected in 2016 (April and May), seven patients with a complaint of aluminum Phosphide poisoning were evaluated at the Addis Ababa Burn Emergency and Trauma Hospital. Four of the patients were female. The ages of the patients ranged from 16 to 33 with an average age of 25. The patients presented to the hospital no earlier than four hours post exposure. Five of the seven patients were farmers. Though the patients were in shock, they were able to provide a history supplemented by the people that brought them to the Emergency Room (ER). They had non-specific manifestations of poisoning including nausea, vomiting, and epigastric and retrosternal pain. In addition, six of the seven patients were in shock. Supportive management with crystalloid resuscitation, ionotropic support, magnesium sulphate, calcium gluconate, hydrocortisone and mechanical ventilation were administered as needed. Five of the seven patients (71%) died in the hospital within 24 hours of ingestion. Because of its lethality; control of the distribution of Aluminum Phosphide in conjunction with the training of health care professionals on early supportive management are essential and may decrease mortality from ingestion of this substance.
Key words: Aluminum Phosphide, pesticide, case fatality, suicide, Ethiopia
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