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

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    Context. Information on childhood poisoning in the developingworld, including South Africa, is scarce, despite its contribution tomorbidity and mortality.Objective. We describe the profile of children with exposuresand poisonings presenting to Red Cross War Memorial Children’sHospital (RCWMCH) in Cape Town, South Africa, from 2003 to2008 and compare the trends of causative agents over the past twodecades.Methods. Cases were identified by review of the RCWMCH caserecords.Results. Of the total incidents (N=2 872), paraffin (kerosene)was the commonest agent (n=692, 24%) with 124 poisoningsincluding two deaths. Drugs were the most common toxin group(n=988, 34%), including 139 single-drug poisonings with 5deaths; 4 associated with traditional medicine use. Householdcleaning product incidents (n=302, 10%) resulted in 29 singleproductpoisonings with no deaths. Pesticide incidents (n=311,10%) included 6 deaths; 203 (65%) incidents were due toorganophosphates or carbamates. The suburban distribution ofthe main toxin groups varied. Comparing 1987 and 2008, thenumber of incidents decreased from 1 116 to 447; drug and paraffinincidents decreased respectively (from 673 to 150 and from 332 to87), household cleaning products and cosmetics increased (21 to69) and pesticide incidents increased (7 to 69).Conclusion. Despite a decrease in the overall number of incidentsover two decades at RCWMCH, paraffin and drugs remainthe principal agents responsible for paediatric exposures andpoisonings, with increasing incidents due to household cleaningproducts and pesticides. Identification of these toxin groups comingfrom specific suburbs allows for targeted prevention initiatives
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