Paraquat poisoning among children in coastal Karnataka: A tertiary care perspective

Background Paraquat is a commonly used agricultural herbicide in India. Poisoning in children is most commonly accidental. Poisoning with paraquat is associated with high mortality rates. The most common organs affected in paraquat poisoning are the kidneys and the lungs, with multi-organ dysfunction being the most common cause of mortality in children. The aim of this study was to the clinical profile and outcome of paraquat poisoning in children at a tertiary care center in coastal Karnataka. Methods A retrospective observational study was conducted at the Department of Pediatrics, at a tertiary care center in coastal Karnataka. In this study, we included patients aged 2 yrs to 18 yrs admitted to the pediatric intensive care unit with acute paraquat poisoning; those with pre-existing renal, pulmonary, and hepatic disease or other poisoning were excluded. The study analyzed data collected in a structured proforma over a period of five years between 1st March 2018 and 28th February 2023. Results A total of 24 patients were included in the study. Most of them were females and above the age of 10 years. The in-hospital mortality was 50%. The volume of paraquat consumed affected the mortality rate, whereas relation of time of presentation with mortality was not significant. Acute kidney and lung injury were the most common manifestations, with multi-organ dysfunction syndrome being the most common cause of death. Conclusion Paraquat poisoning is a major cause of pesticide associated poisoning with very high mortality rate. In the absence of a specific antidote and treatment protocol, it remains to be a major public health concern.