Geographical variation in admissions due to poisoning in Sri Lanka: a time series analysis

Abstract

Objectives: To carry out time series analyses of hospital admissions for poisoning between 1995-2008 in all districts in Sri Lanka to identify trends and geographical variations in the substances used in poisoning. Methods: Data of hospital admissions from 1995-2008 due to poisoning were obtained from the Annual Health Bulletins published by the Ministry of Health. Data were converted to annual rates per 100,000 population. Time trends in the rates of suicide and self-poisoning were calculated using univariate time series analysis. Results: All districts except Kilinochchi and Mullaitivu showed an increase in the rates of admissions due to poisoning with drugs, medicaments and biological substances. Colombo, Hambantota, Kalutara and Anuradhapura showed an exponential increase. Hambantota, Monaragala, Nuwara Eliya and Colombo show an increase in the rate of admissions after pesticide poisoning. All other districts showed a linear decrease. Admissions due to all types of poisoning showed a negative trend in Anuradhapura, Polonnaruwa, Ampara, Matale and Batticoloa districts. Other districts show a positive trend in the rate of admissions for all types of poisoning. Conclusions: Results should be viewed with caution because they are based on analysis of secondary data. Although the rate of suicides has reduced since 1995, admissions due to self poisoning have increased in almost all districts. While pesticide poisoning is becoming less, there is a gradual shift to the use of drugs and medicaments in self poisoning. Poisoning with drugs, medicaments and biological substances are increasing both in urban and rural areas.