Description of 3,180 Courses of Chelation with Dimercaptosuccinic Acid in Children ≤5 y with Severe Lead Poisoning in Zamfara, Northern Nigeria: A Retrospective Analysis of Programme Data
Figure 3
Flow chart of children commencing chelation in period analysed, with inclusion and exclusion in analysis and death outcomes.
Lead was attributed as the primary cause of death where there was a high (>100 µg/dl) VBLL within 10 d before death, where there was no other obvious cause, and where lead toxicity could not be excluded as a cause. Lead was attributed as a contributory cause where a serious comorbidity was present (measles, bronchopneumonia, malaria, septicaemia, or severe malnutrition) but with a recent VBLL> 90 µg/dl. Deaths were categorized as “no clear role of lead” where there was another obvious cause (e.g., fell into an open well, anaemic heart failure, or measles) and no recent VBLL> 65 µg/dl. Reasons for not including in the study cohort were not finishing the chelation course (through defaulting or death before end of course) or no VBLL recorded at end of course. *All died during first treatment course. †Two died during first treatment course.