Carbon Monoxide Poisoning in the Region of Fez-Boulemane, Morocco: Epidemiological Profile and Risk Factors (2009-2012)

Carbon monoxide (CO) poisoning has remained a common, serious and often unrecognized event and constitutes a public health problem in Morocco. The objective of this study is to describe the epidemiological and clinical profile and risk factors of CO poisoning in the region of Fez-Boulemane, Morocco. This is a retrospective study on CO poisoning cases occurred in the region of Fez-Boulemane between January 2009 and December 2012. Data were retrieved from medical records of patients who were admitted to 7 referral hospitals in the study catchment area. The patient's clinical status was classified according to the Poisoning Severity Score. By comparing critical (grade 3 or 4) and non-critical (grade 1 or 2) cases, a univariate analysis was performed to identify the factors associated with life-threatening consequences. During the study period, 2332 cases were included. Most patients were women (68%). The mean (SD) age of patients was 26.4 (16.1) years. Most cases occurred during winter (45.1%). The source of poisoning was water heaters in majority of cases (53%). The most common manifestations were headache in 86%, nausea in 79%, dizziness in 76%, vomiting in 63% and dyspnea in 63% of cases. The majority of patients had grade 2 or grade 1 poisoning severity. Univariate analysis demonstrated that gender (P = 0.03) and the location of event (P = 0.005) had significant impacts on the prognosis while age did not have any influence on the severity of poisoning (P = 0.15). The impact of season of event on the prognosis approached the level of significance but its significance was questionable (P = 0.09). This study showed that CO poisoning is common but probably underestimated in the region. Strengthening the role of the morocco poison control center in the region would be the most effective preventive measure to decrease morbidity and mortality secondary to CO poisoning.