Epidemiological and Clinical Profile of Toxic Ornamental Plant Poisoning in Children: A Retrospective Study from Brazil

Abstract

Background: Ornamental plants commonly found in households and public spaces contain bioactive metabolites such as alkaloids, cardiotonic glycosides, cyanogenic glycosides, calcium oxalate, and toxalbumins. These compounds can trigger clinical manifestations ranging from mild local irritation to severe cardiac arrhythmias and shock. In tropical regions, the high botanical diversity and easy access to such plants increase the risk of poisoning, particularly in children. Objective: To describe the demographic, clinical, and outcome profiles of ornamental plant poisonings, with a focus on pediatric cases, based on notifications reported to a poison control center in Vitória, Espírito Santo, Brazil. Methods: A retrospective and descriptive study was conducted based on 699 reports recorded by the Centro de Informação e Assistência Toxicológica (CIATOX) in Vitória, Brazil. Of these, 600 cases with confirmed botanical identification were analyzed. Variables included age, sex, plant part involved, circumstances of exposure, clinical manifestations, and outcomes. Poisoning severity was classified as absent, mild, moderate, or severe using a logarithmic function and further examined by logistic regression. Statistical analyses were performed using SPSS 21.0. Ethical approval followed the guidelines of Resolution CNS 466/2012. Results: The mean age of affected individuals was 7.8 ± 10.2 years (median: 4 years), with 64.5% aged between 1 and 6 years. Accidental exposure accounted for 92.8% of cases. Leaves (43.7%) and seeds (35.8%) were the most frequently involved plant parts. Poisoning severity was moderate in 73.3% of cases and severe in 14.7%; 54.2% did not require hospitalization. Severe cases were primarily associated with Dieffenbachia picta, Jatropha curcas, Jatropha gossypiifolia, Manihot esculenta, Luffa operculata, Ricinus communis, Trevetia nerrifolia, Brugmansia suaveolens, Joannesia princeps, and Nerium oleander. Greater severity was observed in children under four years of age (p < 0.01) and was significantly associated with the ingested plant part (p < 0.01); no significant differences were found by sex. Conclusions: Poisonings caused by ornamental plants represent a significant public health issue in childhood. Educational interventions targeting families and schools, proper labeling and safe handling of toxic species, professional training, standardized clinical protocols, and public health policies can reduce exposures and associated morbidity and mortality.