Acute Poisoning with Organophosphate Insecticides : A Report of 26 Cases and Literature Review

• nabila choubane

  University of Health Sciences, Faculty of Medicine Youcef El Khatib Department of Emergency Medicine, University Hospital of Algiers, Algeria

Introduction : Acute organophosphate (OP) poisoning remains a major public health concern in regions with intensive agricultural activity. This study aimed to describe the clinical presentation, biological findings, therapeutic management, and outcomes of patients admitted with acute OP poisoning to a tertiary emergency department.

Methods: We conducted a retrospective descriptive study over 12 months (January–December 2023) at the University Hospital of Algiers emergency department. Patients with a confirmed diagnosis of acute OP poisoning were included. Data collected encompassed demographics, clinical presentation, laboratory findings, therapeutic interventions, and patient outcomes.

Results: Twenty-six patients were included, with a mean age of 29.1 ± 10 years. Females accounted for 69.2% of cases, and 65.4% of poisonings were intentional. Muscarinic manifestations were present in all patients, while central nervous system signs and nicotinic manifestations were observed in 42.3% and 19.2%, respectively. The mean plasma cholinesterase level was 800 IU/L. All patients received atropine; pralidoxime was administered in 19.2% due to limited availability. Mechanical ventilation was required in 34.6%, vasopressors in 23.1%, and anticonvulsants in 7.7% of cases. The overall mortality rate was 23.1%, and the mean hospital stay was 11 ± 2.3 days.

Conclusion: Acute OP poisoning is common, severe, and potentially fatal. Early recognition, prompt supportive care, and improved access to specific antidotes such as oximes are crucial. Preventive strategies, including pesticide regulation and psychosocial support, are essential to reduce morbidity and mortality.

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