Unintentional home poisoning among children in rural Ghana: A community survey of knowledge, attitudes and practices.

Jessica Wilkinson1, Jessica Mayer1, Echo Warner2

University of Utah School of Medicine1, University of Utah Division of Public Health2

Background: In 2004, an estimated 346,000 deaths occurred worldwide from unintentional poisonings. We sought to determine caregiver’s knowledge, attitudes and risk factors regarding unintentional poisonings at home in a rural, agrarian district of Ghana’s Ashanti region.

Methods: This cross-sectional survey examined knowledge, attitudes and practices regarding unintentional poisonings of children at home. A semi-structured questionnaire consisting of open- and close-ended questions was developed after a review of research literature. Team members native to the region completed translation of the questionnaire. The questionnaire was pilot tested and modified based on feedback from trial field interviews.  Five towns and villages were sampled to represent a range of population characteristics. Of 121 respondents, 114 from households with children age 1 day to 14 years completed interviews and questionnaires.

Results: Respondents were mostly primary caregivers (84%) and female (81%). Mean age for primary caregivers was 34.5 years. Half of respondents (56%) completed junior secondary school or higher. The most prevalent poison types stored at home were cleaning products (93%, 107/114) and traditional/herbal medicines (73%, 82/112), while 30% reported agrochemicals and 9% reported kerosene. Nearly all respondents identified a poison as a substance that was harmful to health. The most common causes reported for poisonings were improper storage of poisons and young age. Interviewees cited proper storage as a means to prevent poisonings. Many respondents recommended administering palm oil/papaya and rushing the child to the hospital in the event of a poisoning. Some respondents were unaware of what to do in the event of poisoning in the home. Some interviewees indicated that they didn’t believe medications could be poisonous. 

Conclusion: Being such a large burden of disease worldwide, there have not been many in depth analyses of unintentional poisonings. Central to our conclusion was their perception of a poison as a substance that causes general harm with the ability to identify specific substances as poisons rather than others and widely associated community remedies or unawareness of actions to be taken in the event should a poisoning occur. Education programs through schools and local health clinics should be explored as a sustainable and effective intervention. 

Author contact: jessicawilkinson@yahoo.com