The changing trends of childhood poisoning at a tertiary children's hospital in South Africa

• Published in: South African medical journal 2012-03, Vol.102 (3), p.142-146
• Main Authors: BALME, Kate, ROBERTS, J. Clare, GLASSTONE, Marion, CURLING, Linda, MANN, Michael D
• Format: Article
• Language: English
• Subjects: Accident Prevention - methods; Accidents, Home - prevention & control; Accidents, Home - statistics & numerical data; Adolescent; Biological and medical sciences; Child; Child, Preschool; Children; Environmental Exposure - adverse effects; Environmental Exposure - prevention & control; Environmental Exposure - statistics & numerical data; Female; Forecasts and trends; General aspects; Hazardous Substances - poisoning; Hospitals, Pediatric - statistics & numerical data; Hotlines; Household Products - statistics & numerical data; Household Products - toxicity; Humans; Infant; Injuries; Male; Medical sciences; Paraffin - toxicity; Pesticides - toxicity; Pharmaceutical Preparations; Poisoning; Poisoning - epidemiology; Poisoning - etiology; Prevention; Prognosis; Red Cross; South Africa - epidemiology
• ISSN: 0256-9574
• DOI: 10.7196/SAMJ.5149

Information on childhood poisoning in the developing world, including South Africa, is scarce, despite its contribution to morbidity and mortality. We describe the profile of children with exposures and poisonings presenting to Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa, from 2003 to 2008 and compare the trends of causative agents over the past two decades. Cases were identified by review of the RCWMCH case records. Of the total incidents (N=2 872), paraffin (kerosene) was the commonest agent (n=692, 24%) with 124 poisonings including two deaths. Drugs were the most common toxin group (n=988, 34%), including 139 single-drug poisonings with 5 deaths; 4 associated with traditional medicine use. Household cleaning product incidents (n=302, 10%) resulted in 29 single product poisonings with no deaths. Pesticide incidents (n=311, 10%) included 6 deaths; 203 (65%) incidents were due to organophosphates or carbamates. The suburban distribution of the main toxin groups varied. Comparing 1987 and 2008, the number of incidents decreased from 1 116 to 447; drug and paraffin incidents decreased respectively (from 673 to 150 and from 332 to 87), household cleaning products and cosmetics increased (21 to69) and pesticide incidents increased (7 to 69). Despite a decrease in the overall number of incidents over two decades at RCWMCH, paraffin and drugs remain the principal agents responsible for paediatric exposures and poisonings, with increasing incidents due to household cleaning products and pesticides. Identification of these toxin groups coming from specific suburbs allows for targeted prevention initiatives.