Intentional pesticide poisoning and pesticide suicides in Nepal

Figures & data

Figure 1. Map of Nepal showing the hospitals and forensic science laboratories from which data were collected. The size of the circle relates to the case number at each site. Created for this publication using Microsoft excel and QGIS version 3.12.3.

Table 1. Case number and timing by hospital.

Hospital site	N	Percent	Duration of data collection
Janakpur Provincial Hospital	914	22.0	14 April 2017–13 April 2019
Lumbini Provincial Hospital	819	19.7	14 April 2017–16 July 2019
Bheri Provincial Hospital	502	12.1	14 April 2017–16 July 2019
BP Koirala Institute of Health Sciences	501	12.1	14 April 2017–12 Feb 2020
Bharatpur Hospital	474	11.4	14 April 2017–16 April 2019
Western Regional Hospital	327	7.9	14 April 2017–14 Jan 2020
Dhulikhel Hospital	294	7.1	14 April 2018–30 Dec 2019
Tribhuvan University Teaching Hospital	123	3.0	14 April 2017–28 Feb 2019
Bir Hospital	120	2.9	14 April 2017–12 Feb 2019
Patan Academy of Health Sciences	74	1.8	14 April 2017–13 April 2018
Total	4148	100

Notes: We had planned to visit all hospitals for a last time in April–July 2020 but were unable to do so due to the Covid pandemic. The end of data collection, therefore, varies between hospitals.

Table 2. Outcome of the hospital poisoning cases.

Outcome	N	Percent
Discharged alive	1476	64.2
Left against medical advice	222	9.7
Transferred	323	14.0
Died	121	5.3
Discharge on patient request	153	6.7
Absconded	4	0.2
Total	2299	100

Table 3. Classification of agents responsible for death among hospital cases.

Key pesticide	Chemical group	WHO class	N	Percent
Aluminum phosphide	Phosphine gas	NC^a	38	61.3
Methyl parathion	Organophosphorus	Ia	5	8.1
Dichlorvos		Ib	4	6.5
Dimethoate		II	2	3.2
Chlorpyrifos		II	1	1.6
Chlorpyrifos 50% + cypermethrin 5%	Mixed insecticides	II	5	8.1
Zinc Phosphide	Rodenticide	Ib	5	8.1
Total
Cypermethrin	Pyrethroids	II	2	3.3
Sub total			62	100
OP not further identified			2
Total			64

^aNC: not classified.

Figure 2. Types of pesticides identified as being responsible for suicides from CPFSL.

Table 4. Classification of pesticides identified at NFSL.

Key pesticide	Chemical group	WHO class	N	Percent
Dichlorvos	Organophosphorus insecticides	Ib	81	33.4
Chlorpyrifos		II	38	15.7
Dimethoate		II	9	3.7
Triazophos		Ib	9	3.7
Dimethoate and Chlorpyrifos and Malathion		II	1	0.4
Quinalphos		II	1	0.4
Sulfotep		III	1	0.4
Phorate		Ia	1	0.4
Dichlorvos and Dimethoate		Ib + II	1	0.4
Methyl Parathion		Ia	3	1.2
Aluminum phosphide or Zinc Phosphide	Phosphine gas	NC + Ib	57	23.5
Chlorpyrifos and Cypermethrin	OP and pyrethroid combination insecticides	II	27	11.1
Dichlorvos and cyfluthrin		Ib + II	1	0.4
Cypermethrin and Dichlorvos		II + Ib	1	0.4
Triazophos and Deltamethrin		Ib + II	1	0.4
Chlorpyrifos and cypermethrin and Dichlorvos		II + II + Ib	1	0.4
Cypermethrin	Pyrethroids	II	4	1.6
Alphamethrin		II	4	1.6
Deltamethrin		II	1	0.4
Total			242	100