Abstract

Occupational or intentional poisonings involving organophosphate pesticides are common in agricultural areas in Côte d'Ivoire. However, few cases of domestic unintentional acute pesticide poisoning (UAPP) involving banned pesticides and causing the death of several children from the same family have been reported. The aim of this report was to describe the circumstances of the poisoning, the profile of the victims, and the approach to identifying the toxic chemicals involved in the death. The case of three children aged 1, 3, and 7 years old, all siblings, who died suddenly on May 10, 2020, is reported. The WHO International Standard verbal autopsy questionnaire was used to identify a probable underlying cause of death. A cursory autopsy was carried out by the general practitioner of the Urban Health Center, and samples of gastric contents were taken during the postmortem examination. The toxicological analyses were performed by Gas chromatography/electron ionization-mass spectrometry (GC/EI-MS). The three children all died within a 30 min interval between 9:30 and 10:00 a.m., exhibiting a clinical picture of diarrhea, vomiting, bronchorrhea, and respiratory distress. The toxicological analysis of the victims' gastric contents revealed the presence of Disulfoton (C8H19O2PS3), a highly toxic cholinesterase inhibitor (LD50 < 5 mg/kg). This chemical has been banned in the United States and Canada since 2009, and the company Bayer announced the discontinuation of sales in 2011. The findings confirm the toxicity of Disulfoton, a highly neurotoxic molecule, in the death of the three children. However, the circumstances of pesticide ingestion could not be fully elucidated, which challenges regulatory authorities regarding the availability and dumping of banned pesticides in developing countries.

Key words: Fatal poisoning, children, disulfoton, banned pesticide, gas chromatography/electron ionization-mass spectrometry (GC/EI-MS), Côte d’Ivoire.