Deliberate Self-Harm with Household Poisons in Nigeria – Pattern of Presentation and Public Health Implications

Introduction: Across age groups, a wide range of substances are used in deliberate self poisoning (DSP). However, few studies specifically focusing on deliberate self harm with household poisons are available in Nigeria. Methods: We described the characteristics of patients with DSP who presented over a 6 month period at the psychiatric unit of a Teaching Hospital located in a semi-urban community in Nigeria. The types of household poisons, treatment outcomes and implications for suicide prevention strategies in a developing country like Nigeria are reported. Results: In 6 months of its establishment, a total of six patients (4 females and 2 males) with DSP presented in the psychiatric unit of the hospital. All had ingested household chemicals like rat poisons (33.3%), kerosene (33.3%), paraquat insecticide (16.7%) and the powdery contents of a lead battery (16.7%). Patients' mean age was 25years, the mean volume of poison ingested was 23.3ml while the mean time from ingestion of poison to presentation in the hospital was 8.3hrs. All cases were preceded by acute negative life events mostly academic failures (33.3%) and broken relationships (33.3%). The mean hospital length of stay was 4.8days while 33.3% discharged themselves against medical advice. The case fatality (due to paraquat herbicide ingestion) was 16.7%. Conclusions: Cheap but potentially fatal household poisons are readily available in Nigeria and strongly influence the methods used for DSP by community residents. Effective community based prevention approaches should be tailored towards commonly used local methods, restriction in their accessibility and the teaching of coping skills.