Fatalities at the Johannesburg forensic pathology service medico-legal mortuary

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dc.contributor.authorStein, Lauren Mandy
dc.date.accessioned2023-01-25T07:19:41Z
dc.date.available2023-01-25T07:19:41Z
dc.date.issued2022
dc.departmentDepartment of Forensic Medicine and Pathology
dc.descriptionA dissertation submitted in fulfillment of the requirements for the degree of Master of Science in Medicine (Forensic Medicine) to the Faculty of Health Science, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2022
dc.description.abstractDrug use and abuse is a common occurrence worldwide, with significant effects on health, mortality, and morbidity of users. Mental illness being one such negative health effect associated with drug use, with drug users exhibiting signs of depression and anxiety related disorders. Depression has been recorded as a major risk factor for suicidal behaviour, and thus suicide has been identified as a leading contributor to death amongst drug users. South Africa has a high prevalence of suicide cases, however there is minimal data available on the extent and consequences of drug use within South Africa. Due to this high risk of suicide behaviour associated with illicit drug use it is important to assess the prevalence of these drugs in victims of suspected suicide within a South African population. The aim of this study is to describe the incidence of suspected suicide fatalities involving the use of prevalent drugs of abuse (opiates and metabolites, cocaine and metabolites and amphetamine type stimulants and metabolites) in Johannesburg, South Africa. Blood and urine samples were collected from suicide decedents and were analysed using both screening and confirmatory testing. The initial drug screen was performed on an immunoassay-based test (Randox Biochip Array Technology immunoassay). Confirmatory testing was performed using liquid chromatography tandem mass spectrometry (LC-MS/MS). The study results found that 15% of cases had tested as a true positive result for one or more of the targeted drug groups of interest (opiates and metabolites, cocaine and metabolites and amphetamine type stimulants and metabolites). Positive results were noted in multiple methods of suicide such as overdose/poisonings, firearm related, hangings, and gassing/carbon monoxide related suicides. This pilot study has shown that drugs of abuse are present within all methods of suicide fatalities in Johannesburg South Africa. Future recommendations and future research as identified by the results suggests a need for a broader scope of toxicological evaluations within suicide fatalities presenting in Johannesburg South Africa.
dc.description.librarianNG (2023)
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/34224
dc.language.isoen
dc.schoolSchool of Clinical Medicine
dc.titleFatalities at the Johannesburg forensic pathology service medico-legal mortuary
dc.typeDissertation
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