Parental Knowledge, Attitudes, and Practices on Safe Medication Storage and Disposal: A Cross-Sectional Study in Benghazi, Libya

DOAJ (DOAJ: Directory of Open Access Journals) · 2026-01-28

Background: We aimed to assess parents’ knowledge, attitude and practices regarding safe medication storage and disposal. This subject focuses on the first component of the chain of survival behaviors, emphasizing the importance of proactive prevention and preparedness. It underscores the critical necessity of maintaining ongoing situational awareness regarding potential risks and hazards in order to mitigate the occurrence of emergencies. Methods: A cross-sectional study was conducted exclusively within the outpatient department of Benghazi Children’s Hospital in Libya on January 12 and 13, 2025. Data were collected using a structured, interviewer-administered questionnaire. Results: This study, involving 59 parents of children aged 0-6 years, investigated the relationship between various demographic factors and parenting practices and attitudes regarding safe medications storage and disposal. The findings indicated no significant association between a parent's place of residence or educational level and their practices or attitudes. However, a highly significant relationship was observed between the parents' gender and their practices with regard to medications in the home that could lead to a first aid emergency, with mothers demonstrating notably better practices than fathers. Conclusion: Both mothers and fathers generally held positive attitudes towards safe medications storage and disposal; however, mothers exhibited significantly better practices than fathers. الخلفية: يُعدّ التسمم لدى الأطفال مُشكلة صحية عامة عالمية، وسببًا رئيسيًا للإصابات العرضية بين الأطفال. ويؤكّد هذا على الضرورة القُصوى للحفاظ على وعي مُستمر بالمخاطر والتهديدات المُحتملة للحدّ من حدوث حالات الطوارىء، كجُزء من المجال الأول من سلسلة سلوكيات البقاء. المنهجية: أُجريت دراسة مقطعية حصريًا في قسم العيادات الخارجية بمستشفى بنغازي للأطفال في ليبيا. جُمعت البيانات باستخدام استبيان مُنظّم، أُجرِيَ بواسطة المُقابلات، مُقتبس من مُسوحات مُعتمَدة حول المعرفة والمواقف والممارسات ، حول سلامة الأدوية والوقاية من التسمم لدى الأطفال. النتائج: أشارت هذه الدراسة، التي شملت 59 والدًا لأطفال تتراوح أعمارهم من 0 إلى 6 سنوات، إلى عدم وجود ارتباط يُذكر بين مكان إقامة الوالدين أو مستواهم التعليمي وممارساتهم أو مواقفهم. ومع ذلك، لوحظت علاقة ذات دلالة إحصائية بين جنس الوالدين وممارساتهم المتعلقة بالأدوية في المنزل والتي قد تؤدي إلى حالات إسعافات أولية طارئة، حيث أظهرت الأمهات ممارسات أفضل بشكل ملحوظ من الآباء. الخلاصة: تُقدّم هذه الدراسة استكشافًا أوليًا لمعارف الوالدين ومواقفهم وممارساتهم المُتعلقة بالتخزين الآمن للأدوية والتخلص منها بين الآباء في قسم العيادات الخارجية بمستشفى بنغازي للأطفال. وبينما كانت المواقف إيجابية بشكل عام، وُجدت فجوة ملحوظة بين المواقف والممارسات الفعلية، حيث أظهرت الأمهات ممارسات أكثر أمانًا من الآباء. تتوافق هذه النتائج مع الأدلة الدولية. هناك حاجة إلى مزيد من الأبحاث لتأكيد النتائج وتوسيع نطاقها في بيئات أكثر تنوعًا. الكلمات المفتاحية: عرضي، التخلص، الأدوية، التسمم، التخزين. . Usuli: Sumu kwa watoto ni tatizo la afya ya umma duniani kote na ni miongoni mwa sababu kuu za majeraha yasiyokusudiwa kwa watoto. Tatizo hili linaonesha umuhimu mkubwa wa kudumisha uelewa wa mara kwa mara kuhusu hatari na vihatarishi vinavyoweza kusababisha dharura, kama sehemu ya eneo la kwanza la Mnyororo wa Tabia za Uhai (Chain of Survival Behaviors). Mbinu: Utafiti wa mtambuka (cross-sectional) ulifanyika katika idara ya wagonjwa wa nje pekee ya Hospitali ya Watoto ya Benghazi nchini Libya. Takwimu zilikusanywa kwa kutumia dodoso lililopangwa, lililosimamiwa na mhojiwa, na lililorekebishwa kutoka tafiti zilizothibitishwa za KAP (maarifa, mitazamo, na vitendo) kuhusu usalama wa dawa na kinga dhidi ya sumu kwa watoto. Matokeo: Utafiti huu ulihusisha wazazi 59 wa watoto wenye umri wa miaka 0–6 na haukuonesha uhusiano wa maana kati ya makazi ya mzazi au kiwango cha elimu na vitendo au mitazamo yao. Hata hivyo, uhusiano wa kitakwimu ulionekana kati ya jinsia ya mzazi na vitendo vyao kuhusu matumizi na uhifadhi wa dawa nyumbani ambavyo vinaweza kusababisha dharura ya huduma ya kwanza, ambapo akina mama walionesha vitendo bora zaidi kuliko akina baba. Hitimisho: Utafiti huu unatoa tathmini ya awali ya maarifa, mitazamo, na vitendo vya wazazi kuhusu uhifadhi na utupaji salama wa dawa miongoni mwa wazazi wanaohudhuria idara ya wagonjwa wa nje katika Hospitali ya Watoto ya Benghazi. Ingawa mitazamo kwa ujumla ilikuwa chanya, kulikuwa na pengo kubwa kati ya mitazamo na vitendo halisi, huku akina mama wakionesha vitendo salama zaidi kuliko akina baba. Matokeo haya yanaendana na ushahidi wa kimataifa. Tafiti zaidi zinahitajika ili kuthibitisha na kupanua matokeo haya katika mazingira tofauti zaidi. Maneno Muhimu: Ajali, utupaji, dawa, sumu, uhifadhi.

Parental Knowledge, Attitudes, and Practices on Safe Medication Storage and Disposal: A Cross-Sectional Study in Benghazi, Libya

Open MIND · 2026-01-01

Background: We aimed to assess parents’ knowledge, attitude and practices regarding safe medication storage and disposal. This subject focuses on the first component of the chain of survival behaviors, emphasizing the importance of proactive prevention and preparedness. It underscores the critical necessity of maintaining ongoing situational awareness regarding potential risks and hazards in order to mitigate the occurrence of emergencies. Methods: A cross-sectional study was conducted exclusively within the outpatient department of Benghazi Children’s Hospital in Libya on January 12 and 13, 2025. Data were collected using a structured, interviewer-administered questionnaire. Results: This study, involving 59 parents of children aged 0-6 years, investigated the relationship between various demographic factors and parenting practices and attitudes regarding safe medications storage and disposal. The findings indicated no significant association between a parent's place of residence or educational level and their practices or attitudes. However, a highly significant relationship was observed between the parents' gender and their practices with regard to medications in the home that could lead to a first aid emergency, with mothers demonstrating notably better practices than fathers. Conclusion: Both mothers and fathers generally held positive attitudes towards safe medications storage and disposal; however, mothers exhibited significantly better practices than fathers. الخلفية: يُعدّ التسمم لدى الأطفال مُشكلة صحية عامة عالمية، وسببًا رئيسيًا للإصابات العرضية بين الأطفال. ويؤكّد هذا على الضرورة القُصوى للحفاظ على وعي مُستمر بالمخاطر والتهديدات المُحتملة للحدّ من حدوث حالات الطوارىء، كجُزء من المجال الأول من سلسلة سلوكيات البقاء. المنهجية: أُجريت دراسة مقطعية حصريًا في قسم العيادات الخارجية بمستشفى بنغازي للأطفال في ليبيا. جُمعت البيانات باستخدام استبيان مُنظّم، أُجرِيَ بواسطة المُقابلات، مُقتبس من مُسوحات مُعتمَدة حول المعرفة والمواقف والممارسات ، حول سلامة الأدوية والوقاية من التسمم لدى الأطفال. النتائج: أشارت هذه الدراسة، التي شملت 59 والدًا لأطفال تتراوح أعمارهم من 0 إلى 6 سنوات، إلى عدم وجود ارتباط يُذكر بين مكان إقامة الوالدين أو مستواهم التعليمي وممارساتهم أو مواقفهم. ومع ذلك، لوحظت علاقة ذات دلالة إحصائية بين جنس الوالدين وممارساتهم المتعلقة بالأدوية في المنزل والتي قد تؤدي إلى حالات إسعافات أولية طارئة، حيث أظهرت الأمهات ممارسات أفضل بشكل ملحوظ من الآباء. الخلاصة: تُقدّم هذه الدراسة استكشافًا أوليًا لمعارف الوالدين ومواقفهم وممارساتهم المُتعلقة بالتخزين الآمن للأدوية والتخلص منها بين الآباء في قسم العيادات الخارجية بمستشفى بنغازي للأطفال. وبينما كانت المواقف إيجابية بشكل عام، وُجدت فجوة ملحوظة بين المواقف والممارسات الفعلية، حيث أظهرت الأمهات ممارسات أكثر أمانًا من الآباء. تتوافق هذه النتائج مع الأدلة الدولية. هناك حاجة إلى مزيد من الأبحاث لتأكيد النتائج وتوسيع نطاقها في بيئات أكثر تنوعًا. الكلمات المفتاحية: عرضي، التخلص، الأدوية، التسمم، التخزين. . Usuli: Sumu kwa watoto ni tatizo la afya ya umma duniani kote na ni miongoni mwa sababu kuu za majeraha yasiyokusudiwa kwa watoto. Tatizo hili linaonesha umuhimu mkubwa wa kudumisha uelewa wa mara kwa mara kuhusu hatari na vihatarishi vinavyoweza kusababisha dharura, kama sehemu ya eneo la kwanza la Mnyororo wa Tabia za Uhai (Chain of Survival Behaviors). Mbinu: Utafiti wa mtambuka (cross-sectional) ulifanyika katika idara ya wagonjwa wa nje pekee ya Hospitali ya Watoto ya Benghazi nchini Libya. Takwimu zilikusanywa kwa kutumia dodoso lililopangwa, lililosimamiwa na mhojiwa, na lililorekebishwa kutoka tafiti zilizothibitishwa za KAP (maarifa, mitazamo, na vitendo) kuhusu usalama wa dawa na kinga dhidi ya sumu kwa watoto. Matokeo: Utafiti huu ulihusisha wazazi 59 wa watoto wenye umri wa miaka 0–6 na haukuonesha uhusiano wa maana kati ya makazi ya mzazi au kiwango cha elimu na vitendo au mitazamo yao. Hata hivyo, uhusiano wa kitakwimu ulionekana kati ya jinsia ya mzazi na vitendo vyao kuhusu matumizi na uhifadhi wa dawa nyumbani ambavyo vinaweza kusababisha dharura ya huduma ya kwanza, ambapo akina mama walionesha vitendo bora zaidi kuliko akina baba. Hitimisho: Utafiti huu unatoa tathmini ya awali ya maarifa, mitazamo, na vitendo vya wazazi kuhusu uhifadhi na utupaji salama wa dawa miongoni mwa wazazi wanaohudhuria idara ya wagonjwa wa nje katika Hospitali ya Watoto ya Benghazi. Ingawa mitazamo kwa ujumla ilikuwa chanya, kulikuwa na pengo kubwa kati ya mitazamo na vitendo halisi, huku akina mama wakionesha vitendo salama zaidi kuliko akina baba. Matokeo haya yanaendana na ushahidi wa kimataifa. Tafiti zaidi zinahitajika ili kuthibitisha na kupanua matokeo haya katika mazingira tofauti zaidi. Maneno Muhimu: Ajali, utupaji, dawa, sumu, uhifadhi.

Increases in Kratom-Related Reports to Poison Centers — National Poison Data System, United States, 2015–2025

MMWR Morbidity and Mortality Weekly Report · 2026-03-26 · 2 citations

Kratom, the leaves of a tropical evergreen tree (Mitragyna speciosa), is traditionally consumed in Southeast Asia for pain relief, mood enhancement, and to relieve symptoms of opioid withdrawal. Kratom contains psychoactive compounds that interact with opioid receptors and is widely available in various forms in the United States. Its evolution from natural leaf to high-potency alkaloid products has raised concerns about toxicity. Data on kratom-related use that resulted in a report to the National Poison Data System (NPDS) (i.e., kratom exposure report) during 2015-2025 were analyzed to assess trends by exposure report type, demographic characteristics of persons exposed, and outcomes. During the past 11 years, poison centers received a total of 14,449 kratom exposure reports; the record high 3,434 reports in 2025 represent an increase of approximately 1,200% compared with the 258 reports in 2015. Most reports involved males and young adults aged 20-39 years, but reports among adults aged 40-59 years increased most sharply, with rates nearly overlapping with those among young adults by 2025. Although single-substance exposure reports accounted for most reports (62%), multiple-substance reports occurred at higher rates (range = 467-5,442 per 1 million multiple-substance drug exposure reports versus 388-4,045 per 1 million single-substance drug exposure reports), were associated with more hospitalizations (44%-56% versus 24%-29% annually) and serious (life threatening, pronounced, prolonged, or systemic) outcomes (57%-66% versus 41%-49% annually), and accounted for the vast majority of kratom-associated deaths during the study period (184 of 233; 79%). NPDS data indicate that kratom-related reports to poison centers are increasing and expanding among demographic groups, underscoring the value of ongoing surveillance to identify high-risk patterns of kratom use and guide strategies to reduce risks from multiple-substance exposure reports.

Increase in Poison Center Reports Linked to Kratom-Containing Kava Products — National Poison Data System, United States, 2000–2025

MMWR Morbidity and Mortality Weekly Report · 2026-04-02

Kava (Piper methysticum), a central nervous system depressant derived from a plant in the pepper family native to the Pacific Islands, is traditionally consumed in religious, cultural, political, and social ceremonies. In the United States, kava emerged in the late 1990s and has experienced renewed growth and product diversification since the 2010s, with increasing availability of concentrated extracts and ready-to-drink beverages. These commercial products are commonly marketed as healthy alternatives to alcohol, sold near college campuses, and increasingly being combined with kratom, a psychoactive botanical with opioid-like effects, raising safety concerns. Data on kava-related use during January 2000-December 2025 that resulted in a report to the National Poison Data System (i.e., kava exposure report) were analyzed to assess trends by users' demographic characteristics, exposure type, and outcomes. Kava-related exposure reports declined sharply after a 2002 Food and Drug Administration advisory on kava-associated severe liver injury but have risen steadily since 2011, reaching 203 reported exposures in 2025. Reports primarily involved adults aged ≥20 years, but demographic characteristics have changed over time. During 2000-2001, reports primarily involved females and included more children aged ≤12 years, whereas exposure reports since 2013 have predominantly involved men; reports involving children have been rare. Since 2017, reports involving combined use of kava and kratom have increased, reaching 30% (61) of all kava reports in 2025. These increases have coincided with higher rates of serious reported clinical outcomes in recent years (32% in 2025 compared with 12% in 2000). These data indicate a resurgence of overall kava exposure reports to poison centers, as well as an increase in kratom-related kava reports, which has coincided with higher rates of serious clinical outcomes. The findings in this report suggest the need for enhanced surveillance for, clinical awareness of, and public education regarding commercial products containing kava.

127. Optimal Depression Screening Interval Among Students in Higher Education

Journal of Adolescent Health · 2026-02-13

Clinical effects, outcomes, and disposition of unintentional pediatric mushroom exposures reported to United States poison centers from 2009 through 2023

Clinical Toxicology · 2025-07-01

INTRODUCTION: Pediatric exposures to mushrooms can cause distress to parents and healthcare workers due to fear that ingestion could be toxic or fatal. This study aims to characterize the clinical effects, outcomes and disposition of unintentional pediatric mushroom exposures reported to poison centers in the United States over the past 15 years. METHODS: from 2009 to 2023, which analyzes unintentional single-substance mushroom exposures in patients aged 5 years or younger. The primary outcomes were the rate of clinical effects, medical outcomes, and disposition. The secondary outcome was medical outcomes amongst patients who received activated charcoal. RESULTS: There were 50,323 exposures, but no symptoms (89.4%) were reported in the majority of children, and most were managed at home (80.1%). Minor effects were reported in 5.0% of exposures, moderate effects in 0.6% of exposures, and major effects in 0.03% of exposures. Two patients received transplants. In the group of patients who received activated charcoal (7.2%), 7.0% had minor effects, 0.6% reported moderate effects, and 0.05% reported major effects. The type of mushroom was reported as unknown in 92.1% of cases. DISCUSSION: This study shows that clinically significant symptoms and outcomes are rare from unintentional exposures to mushrooms in children aged 5 years or younger, even without mushroom identification. Of 50,323 exposures, major outcomes were reported only in 17. Symptoms were not reported in the majority of children regardless of activated charcoal administration. CONCLUSION: In the absence of symptoms, it may be safe to manage children with unintentional mushroom exposures at home, even without mushroom identification, due to the low risk for adverse outcomes.

Detection of bromazolam alongside other misused substances

Clinical Toxicology · 2025-11-11

INTRODUCTION: Epidemiological and toxicological data available on patients exposed to bromazolam are limited. We report a case series of 32 patients presenting with bromazolam-positive urines. METHODS: Between 1 October and 31 December 2024, 6,083 samples from 5,289 patients presenting to inpatient and outpatient services at four hospitals, were submitted for clinical urine drug screening. Samples were selected for bromazolam confirmation testing if they screened positive for benzodiazepines, fentanyl, cocaine, amfetamines or phencyclidine. A qualitative confirmation method was developed using liquid chromatography tandem mass spectrometry with multiple reaction monitoring. RESULTS: = 24; 69%). DISCUSSION: The bromazolam and fentanyl co-positivity suggests that bromazolam may be increasingly found in illicit fentanyl supplies, heightening the risk for respiratory depression and a lack of full response to naloxone. This pattern may also reflect a co-use pattern among opioid users. CONCLUSION: The study findings highlight the importance of early warning and toxico-surveillance programs powered with advanced analytical confirmation capabilities for timely detection of emerging new psychoactive substances.

Seizures associated with single substance exposures in pediatric patients: a 15-year retrospective study

Clinical Toxicology · 2025-06-30

INTRODUCTION: This study aims to evaluate the trends, demographics, outcomes, and substances associated with single-substance exposures associated with in seizures in pediatric patients over 15 years. METHODS: was conducted from 2009 to 2023, including pediatric patients (<20 years) who experienced seizures as a clinical effect associated with single-substance exposures. Cases with single seizures, multi/discrete seizures, or status epilepticus were included. Trends in annual frequency, seizure rates (per 100,000 exposures), and substances associated with seizures were examined. RESULTS: Thirty thousand nine hundred and eighty-five patients with single-substance exposures associated with seizures were identified, including 1,712 cases of status epilepticus. Reports to poison centers saw an increase in cases with seizures from 1,418 in 2009 to 2,749 in 2023. The seizure rate increased from 88 to 237 per 100,000 exposures. Patients aged 13-19 years accounted for the majority of cases (66.9%), followed by aged 0-5 years (24.0%) and 6-12 years (9.1%). Diphenhydramine and bupropion were the leading contributors, with diphenhydramine-related seizures increasing from 85 in 2009 to 404 in 2023 and bupropion cases rising from 162 in 2013 to 431 in 2023. Moderate and major effects were reported in 41.9% and 35.8% of cases, respectively, with nearly half (47.8%) requiring admission to critical care units. DISCUSSION: The current study shows an increase in substance-related pediatric seizures, particularly among adolescents and females. The significant need for critical care in nearly half of these cases shows the severity and potential long-term impact of these exposures. CONCLUSIONS: Pediatric seizures associated with single-substance exposures are on the rise, driven primarily by diphenhydramine and bupropion. This trend highlights the need for targeted prevention strategies to reduce the burden of toxic exposures and safeguard the well-being of pediatric populations.

Black Widow Spider Exposures: A Retrospective Review of the National Poison Data System 2012–2022

Wilderness and Environmental Medicine · 2024

• Medicine
• Environmental health
• Medical emergency

spp exposures were reported to US poison centers. Exposures occurred with higher frequency in warm-weather states and during summer months. Almost half the cases were managed outside a healthcare facility (48.6%). Hospital admission was required for 10.0% of exposures. The most common therapies received were wound care (43.7%) and benzodiazepines (18.6%). Antivenom was administered in 3.4% (n=521) of exposures.ConclusionsPoison center data indicate that most black widow spider exposures result in minor consequences. Supportive care is the primary approach for black widow spider bites. Although antivenom use is infrequent, providers may seek administration guidance from toxicologists through local poison centers. This study underscores the pivotal role of poison centers in mitigating unnecessary healthcare visits and subsequent hospitalizations.

When Antidiarrheals Stop More Than Loose Bowels: Loperamide-Induced Cardiac Dysfunction

Medical Toxicology · 2024-02-22

Abstract Loperamide is a synthetic over-the-counter opioid medication used as an antidiarrheal agent. It is a substrate of P-glycoprotein, which limits its absorption from the small intestines and penetration of the blood–brain barrier. High-dose loperamide increases plasma concentration following saturation of P-glycoprotein efflux pumps in the small intestines. Co-administration of loperamide with P-glycoprotein, CYP2C8, or CYP3A4 inhibitors will also increase loperamide plasma concentration and decreases metabolism. Central opioid effects can result after overdose. Numerous reports on loperamide toxicity revealed its potential for misuse as an opioid substitute due to its ease of access and low cost. However, the primary toxicity of concern after high-dose loperamide ingestions involves cardiac toxicity. Loperamide inhibits sodium-gated cardiac channels, leading to QRS complex widening and the cardiac delayed rectifier potassium channel, which increases the QT interval and results in increased risk of ventricular dysrhythmias. The management of loperamide toxicity is largely supportive with standard advanced cardiac life support measures. It is noteworthy that loperamide is lipophilic and highly protein-bound, therefore hemodialysis is not expected to be beneficial. IV lipid emulsion can be considered in patients with severe cardiotoxicity refractory to standard measures. In patients with cardiovascular collapse not responding to standard treatment measures, extracorporeal membrane oxygenation may be considered.