title: The changing trends of childhood poisoning at a tertiary children's hospital in South Africa.
abstract: BACKGROUND
  Information on childhood poisoning in the developing world, including South Africa, is scarce, despite its contribution to morbidity and mortality.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  Cases were identified by review of the RCWMCH case records.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Poisons Information Centre, Department of Paediatric Medicine, Red Cross War Memorial Children's Hospital and University of Cape Town, Rondebosch, Cape Town. kh.balme@uct.ac.za
authors.forename: Kate Helene
authors.initials: KH
authors.lastname: Balme
authors.forename: J Clare
authors.initials: JC
authors.lastname: Roberts
authors.forename: Marion
authors.initials: M
authors.lastname: Glasstone
authors.forename: Linda
authors.initials: L
authors.lastname: Curling
authors.forename: Michael D
authors.initials: MD
authors.lastname: Mann
mesh_terms: D000056:Accident Prevention / Q000379:methods; D000061:Accidents, Home / Q000517:prevention & control / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D015386:Hazardous Substances / Q000506:poisoning; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D015277:Hotlines; D006795:Household Products / Q000706:statistics & numerical data / Q000633:toxicity; D006801:Humans; D007223:Infant; D008297:Male; D010232:Paraffin / Q000633:toxicity*; D010575:Pesticides / Q000633:toxicity; D004364:Pharmaceutical Preparations; D011041:Poisoning / Q000453:epidemiology / Q000209:etiology; D012011:Red Cross; D013019:South Africa / Q000453:epidemiology
chemical_list: D015386:Hazardous Substances; D010575:Pesticides; D004364:Pharmaceutical Preparations; D010232:Paraffin