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|Title||Organophosphorus Pesticides Poisoning among Children in Gaza City, Gaza Strip|
Background: Organophosphorus pesticides (OP) are toxic substances frequently used in the Gaza Strip to combat insects, rodents and plants pests and other creatures that can pose problems for agriculture, public health, homes, schools, buildings and communities. Children are the most vulnerable victims for organophosphorus pesticides poisoning (OPP). Objective: To assess risk factors, diagnosed symptoms and biochemical alterations associated with OPP among children in Gaza City, Gaza strip. Materials and methods: In this cross sectional study, data were obtained from questionnaire interview, and biochemical analysis of blood of 104 OP poisoned children aged 1-12 years admitted to El-Dorah and El-Nasser hospitals in Gaza City and 97 healthy individuals as a control group. Data were analyzed statistically by using SPSS program. Results: The total response for the questionnaire interview was 46.2% (n = 48). Eating of poisoned biscuits, bread or meat were commonly contributed to the poisoning cases among children 21 (43.8%). Large number of children sponsors 31 (64.6%) reported the use pesticides in their houses. A total of 4 (8.3%) admitted the recent treatment of their children with head lice. Out of 18 children sponsors, 12 (66.7%) said that they spraying their gardens or farms in the presence of their children and 13 (72.2%) of them reported that they did not store pesticide bottles in safe place. The most common diagnosed symptoms among children were pin point pupils 53 (51.0%), vomiting 46 (44.2%), drawsy 42 (40.4%), conscious 40 (38.5%) and convulsions 30 (28.8%). The mean serum cholinesterase in cases was significantly lower than that in controls (2004.3±1181.9 v 6659.8±1199.2 u/l, % difference= 69.9%, P=0.000). Changes in the enzyme activity was significantly associated with drawsy, conscious and pin point (p=0.001, 0.024 and 0.030, respectively). There was also a statistically significant increase in glucose level of the cases compared to the controls (135.9±44.0 v 69.5±13.1 mg/dl, % difference=95.5, P=0.000). The average levels of serum Alanine Aminotransferase(ALT), Aspartate Aminotransferase (AST) and Alkaline Phosphatase (ALP) in the cases (16.6±6.9, 19.8±8.5 and 319.0±114.3 u/l, respectively) were significantly higher than those in the controls (11.2±2.6, 13.6±4.2 and 245.2±70.1 u/l, respectively) with percentage differences of 48.2, 45.6 and 30.1, respectively and p=0.000. Urea and creatinine levels were increased significantly in the cases compared to the controls (21.0±9.3 v 15.2±5.0 mg/dl, % difference=38.2 and 0.50±0.13 v 0.39±0.11 mg/dl, % difference=28.2, respectively, P=0.000). Potassium and phosphorus were decreased significantly in the cases than the controls (4.0±0.45 v 4.3±0.46 meq/l, % difference=7.0 and 4.1±0.79 v 4.7±1.2 mg/dl, % difference=12.8 p=0.000, respectively). There were also significant decreases in total protein, albumin and globulin in the cases compared to the controls showing % differences of 8.3, 2.8 and 21.8, respectively (5.5±0.80, 3.5±0.39 and 1.97±0.68 v 6.0±0.74, 3.6±0.57 and 2.52±0.72 g/dl, with p=0.000, 0.046 and 0.000, respectively). White blood cell and platelets counts were higher in the cases (14.8±7.0 v 7.5±1.5 X103cell/µl, % difference=97.3 and 398.3±163.6 v 307.2±59.9 X103cell/µl, % difference=29.7 respectively, p=0.000). Hemoglobin and hematocrit were significantly lower in the cases (10.8±1.1 mg/dl and 33.4±3.7% v 12.0±0.87 mg/dl and 37.1±2.4 %, % differences=10.0, p=0.000). MCV and MCH were also found to be significantly lower in the cases (73.16±8.33 fl and 23.61±2.76 pg V 84.13±4.32 fl and 27.25±1.53 pg, % differences=13.0 and 13.4 respectively, p=0.000). Pearson's correlation test showed negative significant correlation between cholinesterase and glucose, ALT, AST or creatinine (r=0.321, 0.291, 0.210, 0.212 and p=0.001, 0.003, 0.032 and 0.030, respectively). On the other hand, positive significant correlation between cholinesterase and phosphorus was achieved (r=0.234, p=0.017).
|Publisher||the islamic university|
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