A descriptive study of aluminum phosphide poisoning cases in Abu Ali Sinai Balkhi Reginal Hospital

Abstract

Background: Aluminum phosphide (AlP) is a highly toxic inorganic compound commercially known as Magic Phos or Celphide, widely used as a fumigant and rodenticide for protecting stored grains. Upon exposure to moisture, AlP releases phosphine gas (PH₃), a colorless, flammable, and highly toxic gas with a garlic or rotten fish odor. In many developing countries, including Afghanistan, AlP is increasingly used in suicide attempts due to its easy accessibility and high lethality.

Methods: To describe the demographic and clinical characteristics, presentation, and outcomes of patients with AlP poisoning admitted to the Internal Medicine Intensive Care Unit (ICU) of Abu Ali Sina Regional Teaching Hospital in Mazar-e-Sharif during the first eight months of 1403 (2024). This was a descriptive cross-sectional study based on a retrospective review of medical records of patients admitted with confirmed AlP poisoning. Data collected included patient age, gender, number and route of tablets consumed, presenting symptoms, and clinical outcomes.

Results: A total of 20 cases of AlP poisoning were recorded. Females accounted for 80% of the cases, with a mortality rate of 81.2%, while males accounted for 20%, with a 50% mortality rate. The majority of patients were under 25 years of age. Common clinical manifestations on admission included vomiting, abdominal pain, cyanosis, and shock. The most frequent cause of poisoning was intentional ingestion for suicide, responsible for 75% of deaths.

Conclusion: AlP poisoning remains a major public health concern due to its high fatality and the absence of a specific antidote. Supportive care is currently the only therapeutic option. Strict regulation of AlP availability, public education on its toxicity, and improved surveillance of its distribution may reduce the incidence and mortality associated with this form of poisoning in Afghanistan.