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Acute poisoning in young children: a 10-year analysis from Ramathibodi Poison Center

Achara Tongpoo1, Kitisak Sanprasert1, Nastayarin Ariyaviraplorn1

  • 1Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospitalal, Mahidol University, Bangkok, Thailand.

Clinical Toxicology (Philadelphia, Pa.)
|July 23, 2026
PubMed

Insights

Pediatric poisoning in Thailand is mainly caused by chemicals and pesticides, unlike in high-income countries. Newborns are the most vulnerable group, facing higher risks of severe outcomes and death from these exposures.

Area of Science:

  • Toxicology
  • Pediatric Health
  • Epidemiology

Background:

  • Acute poisoning is a major cause of preventable childhood illness globally.
  • Data from low- and middle-income countries, such as Thailand, show distinct epidemiological patterns compared to high-income nations.
  • Understanding these unique patterns is crucial for developing targeted prevention strategies.

Purpose of the Study:

  • To investigate the epidemiology of acute poisoning in children under six years old in Thailand.
  • To identify the primary toxic agents involved in pediatric poisonings.
  • To determine risk factors associated with mortality in this population.

Main Methods:

  • A retrospective cohort study was conducted using data from the Ramathibodi Poison Center Toxic Exposure Surveillance System (2011-2020).
  • Multinomial logistic regression analysis was employed to identify independent associations with clinical severity and mortality.
  • A total of 37,076 pediatric exposure cases were analyzed.

Main Results:

  • The most common exposure categories were general-purpose chemicals (45.8%), medications (27.5%), and pesticides (19.0%).
  • Overall mortality was 0.3% (114 deaths), with pesticides, general-purpose chemicals (cyanide), and natural toxins (cobra venom) being leading causes.
  • Newborns were significantly associated with higher mortality (OR 8.26) and severe clinical effects (OR 4.59). Exposure to natural toxins also strongly predicted worse outcomes (OR 5.33).

Conclusions:

  • Pediatric poisoning in Thailand differs from high-income countries, with a higher prevalence of exposure to general-purpose chemicals and pesticides.
  • Newborns represent the most vulnerable demographic for severe poisoning outcomes and mortality in this region.
  • Preventive measures and clinical education should focus on highly lethal, non-pharmaceutical agents prevalent in Thailand, including pesticides, hydrocarbons, and local venomous species.
Abstract

Keywords:
PoisoningThailandhydrocarbonsparaquatpediatricpesticidevenomous snakes

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