The occurrence and management of accidental childhood poisonings in a South African urban suburb: a mixed-methods study
Ahmed, Ayesha Yusuf
Accidental poisoning amongst children is a common childhood injury worldwide, attributed commonly to household substances and medications stored within the immediate environment of the child. The incidence of childhood poisonings in South Africa’s most populated and urbanized province of Gauteng is unknown, due to poor record-keeping at medical facilities regarding the incidence and classification of poisoning, coupled with the lack of a local Poison’s Information Centre (PIC). A mixed-methods, case-study design was used to investigate the occurrence of poisonings and poisons management by parents/guardians and healthcare practitioners in the urban suburb of Gauteng, Lenasia. A cross- sectional, self-administered survey was administered to parents/guardians of children attending a random sample of crèches and primary schools in Lenasia, questioning the number of poisonous household substances stored and storage level of these substances, the occurrence of poisoning incidents amongst children and the associated management and knowledge of PIC's. Semi-structured interviews were used to explore the local practice of healthcare practitioners regarding accidental childhood poisoning. A total of 4530 questionnaires were handed out, 1730 (38.2%) were returned completed and 256 cases of accidental poisoning were reported. Medications were the most common substances stored, followed by cosmetics and household detergents. More than half (63.26%) of all substances were stored at a level of accessibility to children, with pesticides most commonly stored out of reach of children. The occurrence of a poisoning was significantly associated with the employment status of the mother (p=0.031) and the general non-drug chemical category of household substances (p<0.001) The categories of household substances were significantly associated with the level of storage (p=0.021) and the management of poisoning (p<0.001). There is a lack of knowledge of PIC’s and the prevention and management of poisonings amongst parents/guardians. Semi-structured interviews with healthcare practitioners revealed few cases of poisoning presented at healthcare practitioners, however there is a need for improving health literacy amongst caregivers through community awareness programmes and inter-professional development in addressing this preventable phenomenon amongst children.
A Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Medicine in the Department of Pharmacy and Pharmacology