Public Health Surveillance for the Prevention of Pesticide Related Illness in Illinois and Ghana

Background: Pesticides serve useful purposes in both commercial and domestic applications. Despite their usefulness, exposure to pesticides is associated with pesticide related illness (PRI). PRI prevention requires recognition and management of cases on an individual level and a centralized reporting system for targeted prevention on a population level. Aim: The overall aim of this study was to assess the modalities for primary and secondary prevention of PRI in Illinois and Ghana. Methods: State-based data sources in Illinois were explored for their ability to inform public health surveillance on PRI. PRI cases were estimated and characterized through probabilistic data linkage of cases across databases. Data from the Ghana Poison Control Center (GPCC) was analyzed and key informant interviews conducted to assess the potential role of the GPCC for surveillance on PRI. The training needs of healthcare providers in Ghana on PRI was assessed. Results: The Illinois Poison Center (IPC) and health facility-based data sources provided valuable information on PRI cases in Illinois but lacked essential variables necessary for prevention on a population level. Combining multiple data sources through the data linkage process yielded important characteristics about pesticide exposures and illness that were absent from single sources. There were 10, 136 pesticide exposed and PRI cases, 13 deaths, 316 “major” cases”, 1,314 “moderate” cases and 2,291 “minor” cases of PRI. There were 616 poisonings in the GPCC database out of which 15.0% were due to pesticide exposures. Ghana has less efficient data management systems and requires improved human resource capacity for public health surveillance on PRI. Existing collaborations with other state institutions require strengthening. The knowledge and experience in PRI recognition and management of healthcare providers in Ghana is varied. Few have had any specialized training on the recognition and management of PRI, and almost 90% reported that they prefer training through multiple formats. Conclusion: Public health surveillance systems for PRI can be accomplished in a cost-effective way by improving data capture in existing data sources and linking cases across these sources. Collaboration that allows the sharing of data among government agencies is an inexpensive and feasible approach for developing and sustaining PRI surveillance systems. HCPs in Ghana report a need for training on PRI recognition and management, which should enhance care of individuals as well as reporting of cases.