Dear Sir,

We read the article titled ‘Epidemiology of paediatric poisoning presenting to a children’s emergency department in Singapore over a five-year period’ with great interest.(1) Koh et al concluded, “The prognosis of paediatric patients who presented with poisoning in our study was good, with a short median length of stay for those admitted and no fatalities being reported across the span of five years.”(1) We would like to share our ideas and experience on this issue.

In the study, Koh et al found that mothballs and silica gels were common toxic objects. The situation is completely different in our country, Thailand, where the commonest toxic object is over-the-counter drugs, especially antipyretic drugs and laxatives, which are usually kept for general use.(2) While Koh et al’s study had a relatively good outcome, our institution sees a high mortality rate of 3.1% for paediatric poisoning.(2) The differences in social and cultural background between Singapore and our setting might explain the variation in epidemiological patterns. Nevertheless, an important observation common to both studies is the requirement for early management of the case. When focusing on preventive action, attention should also be given to any solid object in the house, and not only drugs, that children might accidentally or intentionally ingest.

Yours sincerely,

Koh SH, Tan KHB, Ganapathy S.Epidemiology of paediatric poisoning presenting to a children's emergency department in Singapore over a five-year period. Singapore Med J. 2018;59:247-50.
Chakreyavanich S.[Pediatric poisoning in Ratchaba Hospital, 2002-2004]. Reg 6-7 Med J. 2006;25:63-71. Thai.