Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117818

Shankar Viswanathan, MSc, Department of Biostatistics and Injury Prevention Research Center, University of North Carolina at Chapel Hill, 137 E. Franklin Street, Suite 500, CB#7505 Bank of America Building, Chapel Hill, NC 27599-7505, 919-843-1532, shankar@bios.unc.edu, Vinu M. Jose, MD, Department of Pharmacology, Government Medical College, Mulamkunnathu kavu, Thrissur, 680596, India, Shrikant I. Bangdiwala, PhD, Biostatistics/CSCC, School of Public Health, University of North Carolina at Chapel Hill, CB# 8030, Suite 203, Bank of America Plaza, 137 E. Franklin Street, Chapel Hill, NC 27514-4145, and Kurien Thomas, MD, MSc, Department of Medicine, Christian Medical College and Hospital, Dr. Ida Scudder Road, Vellore, 632004, India.

Purpose: Cleistanthus collinus (local name: oduvan) poisoning is one of the common suicidal poisoning methods in rural southern India. This study examines the epidemiology of oduvan poisoning cases, highlighting the socio-demographic and clinical profile, complications, and risk factors for mortality.

Methods: A retrospective case series of 127 oduvan intentional poisoning patients presenting between 1990 to 1999 at Christian Medical College and Hospital, Vellore were studied. Descriptive statistics, and cumulative case fatality rates were calculated. Time to death from ingestion of poison was studied using product limit survival estimation; Cox regression modeling adjusting for left-truncation was used to investigate the effect of covariates on outcome.

Results: Patients' average (sd) age was 29.1 (s.d. 10.90), 62% were female, 76% were married and 49% were housewives. The cumulative case fatality was 30%. The probability of survival was 0.88, 0.75, 0.64 and 0.57 at 1, 2, 3 and 5 days respectively. Nearly 74% had hypokalemia. On studying risk factors for death, we observed a statistically significant 58% risk reduction (P=0.0012) in mortality per 1 mmol/l increase in plasma potassium level. Increase in patient's age was also associated with death (HR: 1.05, 95%CI 1.02-1.07). Non-significant but elevated hazards for mortality were seen when administration mode was boiled extract (HR: 1.7, 95%CI : 0.78-3.5) and with chronic disease history (HR: 1.8, 95%CI :0.93-3.67).

Conclusions: Hypokalemia is an important risk factor; patients who are older, with presence of chronic disease, have higher risk for death. Cleistanthus collinus poisoning when consumed as an extract is very lethal.

Learning Objectives:

• The participant should be able describe the clinical profile, sign and symptoms and assess magnitude of problem caused by Cleistanthus Collinus poisoning
• The participant should be able to identify the risk factors for death among the Cleistanthus collinus poisoning patients.
• The participant should be able to develop an intervention strategy to prevent deaths among Cleistanthus collinus poisoning patients

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation