Co esponding au ho : Enock Mu epuka
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In es iga ion o he P e ailing Diagnos ic and Managemen P ac ices o syn he ic
Pes icide Poisoning - ela ed cases in Isoka Dis ic , Muchinga P o ince o Zambia
Enock Mu epuka 1, *, Kaampwe Muzandu 2 and Cha i y Lweya 3
1 Ins i u e o Dis ance Educa ion, Uni e si y o Zambia.
2 Depa men o Biomedical Sciences, School o Ve e ina y Medicine, Uni e si y o Zambia.
3 Depa men o Clima e Change and Na u al Resou ces, Zambia En i onmen al Managemen Agency.
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1683-1690
Publica ion his o y: Recei ed on 29 Ma ch 2025; e ised on 05 May 2025; accep ed on 08 May 2025
A icle DOI: h ps://doi.o g/10.30574/wja .2025.26.2.1759
Abs ac
Syn he ic Pes icides a e chemical subs ances ha a e used o kill pes s ha educe he quali y and p oduc ion o he
ag icul u al c ops. Due o inc ease in Popula ion and demand o ood, he use o syn he ic pes icides has inc eased.
Despi e hei use, hey pose heal h challenges o bo h he en i onmen and humans. Once human beings a e exposed o
pes icides, hey cause bo h acu e and ch onic poisoning. The diagnosis and managemen o he cases a ising om
exposu e o Syn he ic pes icides is he e o e e y c ucial. The pu pose o his s udy was o In es iga e he P e ailing
Diagnos ic and Managemen P ac ices o Syn he ic Pes icide Poisoning -Rela ed cases among P ima y heal hca e
p o ide s o Isoka Dis ic in Muchinga p o ince o Zambia. Da a we e collec ed by means o a ques ionnai e and
analysed using equency and pe cen ages o desc ip i e s a is ics. The e we e di e gence iews among p ima y
heal hca e p o ide s on he Diagnos ic and managemen p ac ices o pes icide poisoning - ela ed cases. While 18%
conduc ed p ocedu es such as Ai way, B ea hing, Ci cula ion and iden i ied he ype o pes icides, 25% gi e IV luids
and ac i a ed cha coal and 13% assess he ype o poisoning. Fu he , 2% we e able o emo e clo hes om he pa ien s
and gi e IV luids while 42% ake his o y. This showed nonexis ence o s anda d p ac ice in he managemen o
pes icide poisoning - ela ed cases. This s udy ecommends he need o p o ide aining on he diagnos ic and
managemen p ac ices o pes icide poisoning- ela ed cases among p ima y heal hca e p o ide s. The s udy u he
ecommend he need o ins i u ion collabo a ion be ween he minis y o heal h and he minis y o ag icul u e.
Keywo ds: Pes icides; Pes icide Poisoning; Diagnosis; Managemen P ac ices; Heal hca e P o ide s
1. In oduc ion
The global ag icul u e consump ion o Pes icides is ocused o inc ease sligh ly o e he nex ew yea s om a ound 4.
3 million me ic ons in 2023 o a alue o a ound 4. 41 million me ic ons in 2027 (S a is ica esea ch depa men ,
2024). This shows ha Pes icides ha e now become an in eg al pa o ou mode n li e and a e used o p o ec
ag icul u al land, s o ed g ain, lowe ga dens om he pes s ansmi ing dange ous in ec ious diseases. Syn he ic
pes icides a e chemical compounds ha a e used o kill pes s including insec s, oden s, ungi, and unwan ed plan s
(ZEMA,2011). O e one housand di e en pes icides a e used a ound he wo ld (WHO, 2020).
Despi e he use o syn he ic pes icides o imp o e he quali y o he c ops and inc ease p oduc ion, hey pose a public
heal h conce n. App oxima ely 740, 000 annual cases o Unin en ional Acu e Pes icide Poisoning (UAPP) occu in 141
coun ies including abou 7446 a ali ies (Boedeke e al, 2020). On his basis, i is es ima ed ha abou 385 million
cases o UAPP occu annually wo ld-wide including a ound 11, 000 a ali ies. Based on a wo ldwide a ming popula ion
o app oxima ely 860 million, his means ha abou 44% o a me s a e poisoned by pes icides e e y yea . A epo by
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A eya ound ou ha e e y one o he a me s in hei in es iga ion a i med ypical symp oms o insec icide poisoning
a e each sp aying ask. These indica ions in ol ed ex eme ce eb al pain (66%), dizziness (58%), body weakness o
being abno mally i ed (55%), nausea (53%), es lessness (37%) and swea ing (41.3%). Pes icide sp aye s epo ed
mo e no ewo hy signs and symp oms such as skin dis u bances, s omach poisoning and eye agg a a ions han o he
a m wo ke s (A eya, 2008).
Di e en classes o syn he ic pes icides pose di e en heal h p oblems. Ca bama e pes icides ha e been implica ed in
he inc easing p e alence o diseases associa ed wi h al e a ion o he immune sys em such as hype sensi i i y
eac ions, and some au oimmune diseases such as cance (Dhouib e al. 2016). Exposu e o O ganophospha e pes icide
b ing abou heal h p oblems including neu ological damage , cance , dis up ion o he endoc ine sys em and e en dea h
(Taiwo, 2019). Mo eo e , in se e e cases o ganophospha e oxici y in p o o ypical pa ien s may exhibi
un esponsi eness, pinpoin pupils, muscles ascicula ion and diapho esis. Addi ional symp oms include emesis,
dia hoea, excessi e sali a ion, lac ima ion and u ina y incon inence (ncbi, 2023). The py e h oids ha e ha e been
implica ed in oxic e ec s ha include neph o oxic, hepa o oxic, ca dio oxic, immuno oxic, neu o oxic and beha iou al
e ec s in humans (Ch us ek e al. 2018). The neonico inoids ha e been implica ed in mu agenici y, endoc ine
dis up ion, Te a ogeneci y, Neu o oxic and Ca cinogenici y ac i i ies.
Acco ding o WHO (2008), he managemen o pes icide poisoned pa ien s a a ious le els o heal h ca e include a
numbe o s ages. The ai way, b ea hing, and ci cula ion (ABC ) o suppo i e ca e is c ucial. I is no possible o o e -
emphasize he need o apply he basic ea men co ec ly in o de o ailo ea men o he pa ien and e alua e he
need o gas ic decon amina ion and also o gi e an ido es ea ly (WHO,2008). In eme gency medical ea men he
ini ial managemen is pi o al despi e a g ea a ia ion. The basic p inciples o ini ial esusci a ion and assessmen a e
o en applied only a e gas ic decon amina ion o which he e is cu en ly no e idence o bene i (Ame ican Academy
o Clinical Toxicology and Eu opean Associa ion o Poison Cen e s and Clinical Toxicologis s, 2004 ). O e all, i a pa ien
is p esen ed wi hin one hou o a heal hca e acili y, he adminis a ion o ac i a ed cha coal should be conside ed i
he pa ien is conscious and gi es consen . Fo ced emesis is no ecommended and O al luids should no be gi en.
Mo eo e , some an ido es a e used in he managemen o pes icide poisoning and a opine is one o he mos impo an
an ido es o pes icide poisoning ha is e ec i e o O ganophospha es and ca bama e poisoning (Eddles on e al,
2008). Howe e , he dosing ecommenda ions gi en in di e en sou ces a y ma kedly and he e is much a ia ion in
how i is gi en in p ac ice (Eddles on e al, 2004). Cu en ecommenda ions a e o gi e oximes o all O ganophospha e
poisoned pa ien s equi ing a opine al hough many pa ien s do no seem o bene i (Eddles on e al, 2005). Acco ding
o Schuman, e al (2015) Addi ional In e en ions is equi ed and while skin and gas oin es inal decon amina ion a e
p og essing, in es iga ion in o he backg ound o he exposu e should be ongoing. Family membe s, co-wo ke s, and
eme gency esponse pe sonnel should be in e iewed o de e mine how he exposu e occu ed by inhala ion, inges ion,
skin con ac , o combina ion.
WHO -UNEP epo o 2016 ou lined ha ca bama e poisoning is diagnosed and managed based on his o y o exposu e
and he cha ac e is ic p esen a ion o musca inic, nico inic and cen al ne ous sys em e ec s o an excess o
ace ylcholine. The diagnosis is con i med by measu ing Ace ylcholines e ase in ed blood cells o plasma and chemical
analysis o body luids (gas ic la age, blood, u ine) should be pe o med o iden i ica ion. WHO, 2006).
WHO-UNEP epo u he indica es ha o o ganochlo ines, managemen should be done by ca ying ou labo a o y
es s o con i ma ion o diagnosis. Poisoning by o ganochlo ines ha e no speci ic an ido e like O ganophospho us ha
a e managed by gi ing an ido e such as a opine, Oximes such as p alidoxime o Obidoxime and Diazepam (WHO, 2006).
Mo eo e , Eme gency managemen o pa ien s p esen ing wi h acu e pes icide poisoning should include bo h clinical
assessmen o he oxid ome and an a emp o iden i y he speci ic compound om his o y, he bo le o pho og aphs.
Iden i ica ion o he speci ic compound inges ed om sel -poisoning is possible in mos pa ien s and is key o p edic ing
and educing complica ions, adminis e ing app op ia e and imely managemen and educing he leng h o hospi al s ay
and cos om unnecessa y medical in e en ions (Lamb e al., 2024)
In con e ence epo by Eddles on ( 2008). i is epo ed ha ea ly managemen is simila o ha o any o he ill pa ien ,
equi ing assessmen o Ai way, B ea hing, and Ci cula ion, and esusci a ion wi h oxygen and luids. Posi ioning o he
pa ien in he ‘Le La e al Posi ion’ is impo an because omi ing is common and aspi a ion o he pes icide may cause
a al aspi a ion pneumoni is and pneumonia.
Acco ding o Robe s and Reiga (2013), When you suspec a pes icide poisoning, y o ge as much in o ma ion abou
he pes icide(s) as possible, including: he name o he pes icide used, he EPA pes icide egis a ion numbe , and he
pes icide label and/o he Ma e ial Sa e y Da a Shee (MSDS) o he pes icide(s). Mo eo e . Robe s and Reiga (2013)
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1683-1690
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adds ha i i is impo an o Ob ain an unlaunde ed sample o clo hing ha he pa ien was wea ing a he ime o he
inciden , i a ailable. Pu i in a plas ic bag o p e en u he exposu e and o p ese e he specimens o subsequen
analysis; eezing is op imal. I can be di icul o ind app op ia e clo hing o sample i he wo ke has been ins uc ed
o go home and ho oughly wash his/he clo hing. I mos clo hing has been washed o is no a ailable, i is likely he
pa ien ’s ha o shoes would s ill be con amina ed and could be analyzed
In zambia pes icides use in ag icul u e is inc easing wi h nea ly 43% o he a me s using hem e e y season (CABI,
2025). Mo eo e , inadequa e en o cemen o exis ing laws and con inued use o highly haza dous pes icides (HHPs)
a ec he heal h o he child en. he elde ly. p egnan mo he s and he gene al public-which is being discussed as a
human igh issue. (IPEN, 2019)This means ha he a me s a e a isk o he heal h e ec s ha hese pes icides cause.
I is agains his backg ound ha his s udy in es iga ed he p e ailing diagnosis and managemen p ac ices o syn he ic
pes icides poisoning ela ed cases in isoka Dis ic o Muchinga p o ince in zambia.
This s udy sough o in es iga e he p e ailing diagnosis and managemen p ac ices o syn he ic pes icide poisoning -
ela ed cases in Isoka Dis ic , Muchinga p o ince o zambia.
2. Ma e ials and Me hods
2.1. S udy Loca ion
Isoka Dis ic (10°2'4''S, 32°6'1''E) is loca ed in he No h Eas e n pa o Zambia in he ecen ly c ea ed Muchinga
P o ince. I is bo de ed by Nakonde Dis ic o he No h, Chinsali Dis ic o he Wes , Chama Dis ic o he Sou h and
Malawi o he Eas .
2.2. S udy Design
This s udy employed a c oss-sec ional su ey and explana o y esea ch design. The adop ed esea ch design in ol ed
he collec ion o p ima y da a a a pa icula poin in ime ha is use ul in ob aining ac s and pe cep ions o he
esponden s. This was combined wi h explo a i e app oaches h ough in-dep h in e iews ha e ealed mo e abou
he Managemen p ac ices o pes icide poisoning - ela ed cases in Isoka Dis ic .
2.3. Ta ge Popula ion
This s udy a ge ed he p ima y heal hca e p o ide s wo king in he heal h acili ies o Isoka Dis ic .
2.4. Inclusion and Exclusion c i e ia
Those who we e included in his s udy we e he nu ses, clinical o ice s, medical Doc o s, En i onmen al heal h
pe sonnel and labo a o y echnologis s who we e ound wo king a he dis ic heal h hospi al and Kasoka heal h
acili y on he day da a collec ion ook place and hey illed in he consen o ms. The cleane s and hose who we e ound
wo king a he egis y we e excluded om his s udy.
2.5. Sample Size o p ima y heal hca e wo ke s.
The minimum sample size was calcula ed using Coch an’s o mula in i s modi ica ion s a e.
n= N/1+(N/1000) whe e n = sample size, N=popula ion size.
n = 50/1+(50/1000)
n=33
Thus, he sample size o his s udy was 33 p ima y heal hca e wo ke s.
While he a ge ed sample size was 33. i e (5) pa icipan s did no b ing he ques ionnai es back educing his numbe
o wen y eigh (28)
2.6. Da a collec ion and Analysis
Da a we e collec ed using a semi-s uc u ed ques ionnai e. In he i s pa , he ques ions had op ional answe s such as
‘Ag ee. Disag ee. Unce ain’. In he nex pa he ques ions we e open o he pa icipan s o exp ess hemsel es eely
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1683-1690
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when answe ing. Da a analysis we e pe o med h ough SPSS e sion 20 and Excel s a is ical packages o 2013. The
Desc ip i e s a is ics we e he use ul pa ame e s o in e es p oposed unde his s udy. The equency and pe cen ages
we e calcula ed.
2.7. E hical Conside a ions
Be o e espec i e go e nmen Depa men s such as he minis y o ag icul u e and Minis y o heal h we e in o med
o he esea ch unde aking. E hical clea ance was ob ained om excellence in esea ch e hics and Sciences (ERES ) Re .
no. 2022-Aug-017. All pa icipan s we e in o med abou he su ey be o e pa icipa ing and had he igh o wi hd aw
a any poin in ime du ing he su ey. Fo da a ha we e collec ed om p ima y heal hca e wo ke s, hey we e made
o sign an in o med consen be o e being en olled in he su ey.
3. Resul and Discussion
Table 1. The able p o ides esponses o he ques ions in he ques ionnai e by he p ima y heal hca e p o ide s abou
he managemen and p ac ices o pes icide poisoning ela ed cases in Isoka Dis ic .
Table 1 Managemen P ac ices o Pes icide poisoning ela ed cases in Isoka Dis ic
SN
Desc ip ion o s a emen
F equency
Pe cen age
(%)
1
We easily ecognise pes icide poisoning om he p esen a ion o signs and
symp oms by he clien s exposed o pes icides
Ag ee
20
71
Disag ee
7
4
Unce ain
1
25
2
Following pes icide exposu e, we eques o a copy o pes icide label om
ou ou clien s
Ag ee
6
21. 5
Disag ee
16
57
Unce a in
6
21. 5
3
Clien s suspec ed o pes icide poisoning a e asked o p oduce ma e ial sa e y
da a shee
Ag ee
7
25
Disag ee
10
36
Unce ain
11
39
4
We a e able o collec whole blood, plasma o esh u ine om pes icide
poisoned pa ien s o analysis and possible diagnosis
Ag ee
3
11
Disag ee
15
53
Unce a in
10
36
5
We a e able o collec any con amina ed clo hing. ha s, oliage om he si e
and ake hem in clea sealable plas ic bags
Ag ee
7
25
Disag ee
9
32
Unce ain
12
43
Wo ld Jou nal o Ad anced Resea ch and Re iews, 2025, 26(02), 1683-1690
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6
Medica ion o managing pes icides poisoning a e eadily a ailable a ou ou
acili y.
Ag ee
10
35. 7
Disag ee
12
42. 9
Unce a in
6
21. 4
7
Pes icide poisoning a e u he epo ed o he Dis ic o ice, P o incial o ice.
Minis y o heal h. Local go e nmen public heal h depa men and zambia
En i onmen al managemen Agency.
Ag ee
8
28. 6
Disag ee
12
42. 8
Unce ain
8
28. 6
8
A e ea men clien s usually ecei e counselling and heal h educa ion on
pes icides
Ag ee
23
82
Disag ee
3
11
Unce ain
2
7
Abou 71% o he p ima y heal hca e p o ide s we e able o ecognise pes icide poisoning om he p esen a ion o
signs and symp oms by he clien s exposed o pes icides while 4% we e no able o ecognise he poisoning cases and
25% we e unce ain. wi h ega d o he copy o pes icide label, 21. 5% we e able o eques o a copy while 57% did
no eques o a copy and 21. 5% we e unce ain abou eques ing o a copy o pes icide label. A copy o pes icide label
p o ides impo an in o ma ion on he ac i e ing edien in he pes icides con aine . Some labels con ain in o ma ion
on how o ca y ou i s aid ha could be e y ele an in e ms o helping he p ima y heal hca e p o ide make
co ec decision on managemen o he cases. Abou 25% o p ima y heal hca e p o ide s ask clien s suspec ed o
pes icide poisoning o p oduce ma e ial sa e y da a shee while 36% did no and a u he 39% we e unce ain.
Mo eo e , 11% we e able o collec whole blood. plasma o esh u ine om he clien s exposed o pes icides o
analysis and possible diagnosis while 53% we e no able o collec any sample and a u he 36% we e unce ain.
Analysis o he samples is c ucial because he ype o pes icide will be iden i ied and co ec medica ion will be p o ided.
This is because di e en ypes o pes icides ha e di e en ways o ea men . The way o ganophospha es a e ea ed is
di e en om he way O ganochlo ines, Ca bama es and neonico inoids may be ea ed.
In his s udy, 25% we e able o collec con amina ed clo hing, ha s, oliage om he si e and ake hem in a clea sealable
plas ic bag while 32% did no and 43% we e unce ain. When con amina ed clo hing a e collec ed, hey could be used
o sample ex ac ion in he labo a o y so ha he ype o pes icide is iden i ied. The esul s o his s udy showed ha
mos o he p ima y heal hca e p o ide we e no able o collec con amina ed clo hing he e by making diagnosis
di icul o hem. Fu he , 35. 7% con i med he a ailabili y o medicines o he ea men o pes icide poisoning cases
while 42. 9% exp essed non a ailabili y o hese medicines while 21. 4 % we e unce ain. Wi h ega d o epo ing o
he cases o high au ho i y he esul s o his s udy showed ha 28. 6% epo ed he cases while 42% did no and 28.
6% we e unce ain. Abou 82% o he p ima y heal hca e p o ide s p o ide counselling and heal h educa ion on
pes icides while 11% did no and a u he 7% we e unce ain. I is e y impo an ha pes icide poisoning - ela ed
cases a e epo ed o ele an au ho i ies such as he minis y o heal h so ha hey plan on he pu chase o he
medica ion as hey a e he ones cha ged wi h he esponsibili y o p o iding medical supplies. The esul s o he p esen
s udy con adic hose o Robe and Reiga who emphasized he need o collec as much in o ma ion as possible om
he labels and ma e ial sa e y da a shee in o de o co ec diagnosis o be made.
Table 2. This able is abou he s eps ha p ima y heal hca e p o ide s ake when managing chemical pes icides
poisoning ela ed cases in Isoka Dis ic .
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Table 2 Explana ion o some ew s eps aken in managing chemical pes icide poisoning ela ed cases
SN
CODE
PERCENTAGE
1
Code:Conduc ABCD and Iden i y.
Fi s you conduc ABCD, iden i y he ype o chemical pes icide he pa ien has been exposed o
and gi e medica ion o ha chemical.
18%
2
Code:IV luids and Ac i a ed Cha coal
Adminis e ing ac i a ed cha coal and milk
Adminis e ing ac i a ed cha coal. milk o neu aliza ion and luids
25%
3
Code: Assess
Assess o he ype o poisoning
we assess o he clinical ea u es, ype o poisoning and le el o poisoning hen ea men .
13%
4
Code:Remo e Clo hes
i s by emo ing he clo hes. gi e luids
emo e clo hes
emo e clo hes
Remo e clo hes. gi e hem an i-in lamma o y
2%
5
Code:Take His o y
Take his o y. examine. expose he pa ien . esusci a e and educa e he pa ien .
42%
Abou 18% said hey conduc ABCD and iden i y he ype o pes icides while 25% said hey gi e IV luids and ac i a ed
cha coal and 13% said hey jus assess he ype o poisoning. Fu he 2% said hey emo e clo hes om he pa ien and
gi e IV luids and 42% said hey ake his o y. The esul s o ou s udy e eals di e gence iews in e ms o p e ailing
diagnos ic and managemen o pes icide poisoning - ela ed cases. This could be due o non a ailabili y o he p o ocol
o handling cases ela ed o pes icides. The esul s o ou s udy unde sco e he impo ance o ollowing co ec s eps
when sc eening o pes icide poisoning- ela ed cases in o de o ensu e accu a e de ec ion, minimize isks o human
and en i onmen al heal h and p e en po en ial misuse o he medica ions. ul ima ely leading o sa e and mo e
e ec i e pes managemen s a egies. The esul s o he p esen s udy a e in line wi h hose o WHO (2008) who
emphasized on he impo an o pe o ming necessa y s eps such as ai way ,b ea hing and ci cula ion .
4. Conclusion and ecommenda ion
The e we e di e gence iews among p ima y heal hca e p o ide s in e ms o he p e ailing diagnos ic and
managemen p ac ices indica ing non exis ence o s anda d p ocedu e in dealing wi h pes icide poisoning - ela ed
cases. P ima y heal hca e p o ide s did no ake adequa e his o y when dealing wi h clien s ha a e poisoned by
pes icides.The p ima y heal hca e p o ide s did no conduc ho ough assessmen o he ype o pes icides ha caused
he poisoning.The p ima y heal hca e p o ide s did no conduc adequa e decon amina ion.This s udy ecommends
he need o sensi ize he p ima y heal hca e p o ide s on he heal h e ec s o pes icides and p o ide aining on he
diagnos ic and managemen p ac ices. The clien s we e able o ecei e counselling and heal h educa ion ega ding he
pes icides.The s udy ecommend he need o p ima y heal hca e p o ide s o ake adequa e his o y,conduc
assessmen o he ype o pes icide poisoning and ca y ou decon amina ion co ec ly .The e is need o collabo a ion
h ough mul i-sec o al app oach o con ol and p e en ion o syn he ic pes icide poisoning - ela ed cases especially
he minis y o ag icul u e , Minis y o heal h and he Zambia en i onmen al managemen agency.
Compliance wi h e hical s anda ds
Acknowledgmen s
The Au ho s wish o acknowledge he suppo o he managemen a bo h Dis ic and heal h acili y le el. The
pa icipan s we e e y coope a i e in esponding o he ques ions in he ques ionnai e.
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Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
S a emen o e hical app o al
E hical clea ance was ob ained om Excellence in Resea ch E hics and Sciences (ERES). Re . no.2022-Aug-017.All
pa icipan s we e in o med abou he s udy be o e pa icipa ing and had he igh o wi hd aw a any poin in ime
du ing he s udy pe iod.
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
Decla a ion o compe ing in e es s
The au ho s decla e no con lic s o in e es in he p esen s udy.
Re e ences
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