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Home Safety Practices for Prevention of Poisoning in Young Children
At baseline Audit 1, 40.4-56.8 of households in the Kinta District were found to be safe in prevention of poisoning compared to 14.7-28.0 in the Manjung District.
In Kinta, more households 66.8-81.2 were safe for prevention of household chemicals poisoning compared to medication poisoning 43.9-60.3. In Manjung,
the rates for safety from household chemicals poisoning and medication poisoning did not differ much at 28.2-43.8 and 33.4-49.3, respectively.
However only 30 20.4 households in the Kinta District compared to 79 52.7 households in the Manjung District had good knowledge when assessed at audit
1. Households in Kinta and Manjung had similar high rates in perceiving their children to have no access to medication and household chemicals, 77.4 and
81.6 respectively in Kinta and 81.3 and 80.7 in Manjung.
The percentage of safe households in the Kinta District improved significantly to between 60.2-76.0 after Audit 2 and further to between 89.7-98.0 after Audit 3.
Manjung also showed significant improvement to between 52.6 – 69.1 after Audit 2 but plateaued at 59.7-75.6 at Audit 3. The sustained improvement in Kinta District
may be attributed to the Safety Device.
Knowledge does not affect practice as demonstrated by the findings from the Manjung District.
Number of poisoning in children in the past year was 4 0.91 in the Kinta District and 6 1.26 in the Manjung District. The incidence of poisoning per 1000 children
per year in the Kinta District was 9.11 compared to 12.55 in the Manjung District.
In Audit 2, 88.4 households were satisfied with the device and this was sustained in Audit 3. However, satisfaction or dissatisfaction with the device did not affect
safety practices in the household.
5.2 Strengths and Weaknesses of the Study
This study did not assess post intervention knowledge at Audit 2 and Audit 3 as it was considered that the audit conducted with carers was superior to conventional
health education using leaflets.
There was no control group as it will be unethical not to intervene in those households at risk. The Manjung district was used as a “partial control” as no safety device was
provided in the intervention package.
The population studied only represented urban and semi-urban households and not the rural population. Spoken language use was limited to Bahasa Malaysia and
English. Chinese and Tamil was not included although around 34 of households used either one of these languages. However the safety educational material was
made available in 4 languages Bahasa Malaysia, English, Chinese and Tamil.
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Home Safety Practices for Prevention of Poisoning in Young Children
This study did not evaluate the use of the safety device. Instead, the study focused on evaluating the satisfaction of caregiver with the device. The majority of caregiver
involved in the study was female and this may have contributed to the success of the intervention.
5.3 Strengths and Weakness in Relation to Other Studies Rate of Unsafe Households
This study shows 60-71 of urban and semi-urban households in Perak have unsafe homes. The figure is comparable to a study done in urban lower income households
in the USA where 77 of homes were not safe in preventing poisoning in children Kimberly E. et al. 2007.
Improvement Rate of Safe Household
In this study, good knowledge and high perception did not affect practice. This is similar to finding in other studies. A study in Turkey shows that 69 of mothers
claimed to have taken preventive measures after their child had a poisoning accident at home but they did not even mention at all basic precautions such as storage of
poisonous agents on different shelves and storage of medication and household chemicals in locked cabinets Sibel E. et al. 2006. 76.1 of mothers only mentioned
keeping the medication out of the reach of children.
The study in the USA also shows that caregiver reports of poison safetystorage 71 were falsely higher than if evaluated by a home safety checklistaudit 17 Kimberly
E. et al. 2007. This strongly suggests that home audit rather than conventional education or questionnaire alone is a more powerful tool to identify unsafe home
as well as to make significant changes in practices. The audit not only gathers information but also educates the respondents and ensures that correct practices
are adhered to.
The use of the safety device may have contributed to further improvement but this needs to be studied further.
Community-based prevention educational programmes are an important component in preventing poisonings and have been shown to change parental poison storage
habits Maiesl G. et al. 1967 as quoted by John T. Arokiasamy in an editorial Accidental Poisoning: Selected Aspects of its Epidemiology and Prevention Med. J. Malaysia
June 1994.
The rate of poisoning in household participating in this study was 1.1 over a one year period. This is lower than the average calculated from accidental poisoning in
Perak for children aged 1-4 years which was 3 HMIS data, MOH 2003-2007 and international data for developing countries 5 Kimberly E. et al. 2007. The rate is
