Trends in the Intentional and Non-intentional Poisoning-related Calls among Adolescents Reported to the Malaysia National Poison Centre (2010-2020)

Abstract

This is an analysis of the intentional and non-intentional poisoning-related calls involving adolescents with a special focus on intentional pharmaceuticals-related exposures. The study consists of descriptive and comparative analyses of calls made to the Malaysia National Poison Centre between 2010 and 2020. Bivariate analyses were made using cross-tabulation with Chi-square test and binary logistic regression was used for multivariate analysis. A p value of <0.05 was considered statistically significant. Of 48355 poisonings reported, 4632 (9.6%) cases were adolescents. This analysis was performed on 3991 cases with complete information, of which 3133 were intentional. Of all intentional poisoning cases, 44.2% involved pharmaceutical substances. Female adolescents were more likely to be involved in intentional pharmaceutical poisoning than males (70.5% vs 29.5%, p<0.000). Analgesics were the most often pharmaceutical agents ingested by adolescents (11.3%), followed by psychiatric drugs (7.6%), and mixed pharmaceutical agents (5.4%). Paracetamol was the most frequently ingested single agent involved in 345 cases. Suicidal intent was the most frequent reason for intentional poisoning (85.8%), followed by misuse, unknown, and drug abuse, accounting for 5%, 4%, and 3.4% instances, respectively. Analgesics appeared to be the most common drug class, with paracetamol representing the highest single agent used in poisoning among adolescents. Incidence rates for poisoning exposure among adolescents were declining in general from 18.3 per 100,000 population in 2010 to 6.9 per 100,000 population in 2020. However, there were periods of increases in 2014 and 2018 followed by declining rates. Multivariate analysis indicated that intentional exposures were more associated with female gender, Indian and Chinese ethnicities, and pharmaceutical ingestions (all p value, 0.001). These findings emphasize the importance of developing customized prevention strategies in collaboration with stakeholders to ensure that appropriate interventions are considered at multiple levels of intervention.