Intentional Chloralose Poisoning in a Low-Resource Setting: Epidemiology and Short-Term Outcomes from a Tunisian emergency department

• hela ben turkia

  regional hospital of Ben Arous

• Ibtissem Ben Taher

• Amira Bekir

• Raja Fadhel

• hanene ghazali

• Sami Souissi

Abstract:

Background: Intentional self-poisoning with chloralose remains an issue in low- and middle-income countries, where α-chloralose rodenticides are easily accessible. Data from frontline emergency departments are limited.

Objective: To describe the epidemiological, clinical, management, and short-term outcome profile of intentional chloralose poisoning in a polyvalent emergency department,

Methods: We conducted a prospective descriptive study in the emergency department of regional hospital in Tunisia from January 2018 to December 2022. All patients aged ≥18 years with intentional ingestion of an α-chloralose, confirmed by history and/or toxicological analysis, were included. Sociodemographic data, clinical features, investigations, treatment, disposition, and outcomes were collected, and suicidal intent was assessed using the Suicide Intent Scale (SIS).

Results:

Inclusion of 35 patients, among 1812 poisoning cases over the study period. The mean age was 28 ± 11 years and 71.4% were women. Forty percent had a psychiatric history, and interpersonal conflict was the most frequent precipitating factor (68.5%). The median time to presentation was 2.5 hours. On admission, 48.6% had a Glasgow Coma Scale score <13 and 28.6% had a score ≤8; tremors and seizures occurred in 57.1% and 5.7% of patients, respectively. Orotracheal intubation was required in 57.1% of cases, 57,1% were transferred to intensive care, and no deaths occurred during emergency department stay. The median SIS score was 7 (range 0–22), with 71.3% of patients exhibiting moderate-to-high suicidal intent.

Conclusion: Intentional chloralose poisoning in this setting predominantly affects young women with psychiatric vulnerability and presents with severe but reversible neurological toxicity, frequently requiring organ support but associated with excellent short-term survival under supportive care.

• PDF

Copyright (c) 2026 Tunisian Journal of Emergency Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.

THE tjem allows authors to retain unrestricted copyright and full publishing rights of their articles.

All articles published in this journal are openly accessible and licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This guarantees that anyone is free to:

• Share: Copy and redistribute the material in any medium or format.

• Adapt: Remix, transform, and build upon the material for any purpose, even commercially.

Under the following terms:

• Attribution: Users must give appropriate credit to the original author(s) and the journal, provide a link to the license, and indicate if changes were made.

By submitting a manuscript to tjem, authors grant the journal the right of first publication, while retaining full ownership of their intellectual property.