Community Experience with Unintentional Kerosene Ingestion in Greater Accra, Ghana

Poisoning is among the top three causes of injury worldwide. While developing countries share this burden, epidemiologic studies are often lacking and experiences from developed nations cannot necessarily be generalized. This study was conducted in partnership with New York University, The New York City Poison Control Center, and the Ghana Poison Control Center to describe the community experience with kerosene exposures in Greater Accra, preliminary to a public health campaign for primary and secondary prevention. Methods: A semi-structured interview was developed using a health belief model of behavioral change, and conducted with a convenience sample of 101 community members. Probing questions assessed understanding of the dangers associated with kerosene, susceptibility to unintentional poisoning by kerosene ingestion, barriers to safe storage of kerosene in the home, and methods of poison prevention. Results: 36% of interviewees told personal stories about kerosene ingestion by children they knew. 55% stored kerosene at home in used water bottles that lacked child-resistant closures. Water bottles were used preferentially for safety reasons since they can be capped, an improvement compared to storage in glass soda or beer bottles that have flip-off caps. Cost and availability were major barriers to storage in original or child-resistant containers. Conclusion: Community members in Greater Accra are concerned about the danger of kerosene ingestion, and link susceptibility to unsafe storage. Lack of resources is perceived as the major barrier to safe storage. We conclude that a prevention campaign to decrease unintentional kerosene ingestion by children should emphasize safe storage methods.