A Profile of Acute Poisoning at Selected Hospitals in South Africa

The aim of this study was to characterise acute poisoning cases admitted to a number of selected hospitals in South Africa. All cases admitted to eight hospitals; from January 2005 to June 2005; were evaluated retrospectively. Data obtained from the hospital medical records included the following: demographic characteristics; toxic agents; length of hospital stay; circumstances of poisoning; morbidity and mortality information on the poisoned patients. From a total of 424 patients admitted for treatment; whose median age was 17.6 years; 57.8were females; and 89.6black Africans. Fifty-nine percent of the poisonings were accidental; and the involved toxic agents were; in descending order: household chemicals (45.7); modern medicines (17.5); animal/insect bites (15.8); agrochemical chemicals (9.7); food poisoning (5.4); drugs of abuse (3.3); traditional medicines (2.4); and plants (0.2). Poisoning by drugs of abuse was commoner in males than females; but the percentage of females poisoned by all other toxic agents was higher than in males. Most patients spent less than two days in hospital; but more females (70.1) than males (29.9) stayed for more than two days. The overall case fatality rate was 2.4. Of those who died; 80were black Africans; aged 13 to 19 years and it was deliberate poisoning through drugs of abuse; carbon monoxide and agricultural chemicals. Acute poisoning reviewed in some selected hospitals in South Africa revealed that more black African females were involved; who spent more than two days hospitalised. The case fatality rate was 2.4; mainly due to drugs of abuse; carbon monoxide and agricultural chemicals. These findings suggest that further studies are needed to understand the motivation(s) for this emerging problem and that these should focus primarily on the female black African

Predictors of Topical Steroid Misuse among Patrons of Pharmacies in Pretoria

The misuse of topical steroids; i.e. the usage of these products for skin lightening; is a widespread phenomenon among African men and women. Studies have reported prevalence rates of 18.5to 70 among participants. Though women constitute the majority of users; people of various age groups; socioeconomic status; employment and marital status practise skin lightening. Besides topical steroid products; other commonly used products include preparations containing hydroquinone or mercury derivatives. The misuse of these products is associated with skin problems such as cellulitis; contact eczema; bacterial and fungal infections; Cushing's syndrome; acne; skin atrophy and pigmentation disorders. Although these effects are well documented; it seems that there is little wareness of them among the general public. Other less commonly reported problems include delaying the diagnosis of leprosy; and erythrodermic psoriasis. Data on the misuse and side effects of topical steroids have been gathered primarily from prescriptions; despite the fact that these products could be obtained over the counter; shared between relatives or friends; or come from other informal sources. Moreover; we found no community-based study that investigated the prevalence of the misuse of topical steroid products in South Africa. This survey was therefore conducted to examine the misuse of topical steroid products for skin lightening; among patrons of pharmacies in Pretoria and to determine the potential predictors of misuse.Methods: The aim of this study was to examine the misuse of topical steroid products for skin lightening by patrons of pharmacies in Pretoria and to determine the potential predictors of misuse. Exit interviews were conducted at 21 randomly selected pharmacies by trained interviewers using a structured questionnaire. A total of 1 228 patrons were approached; of which 225 gave verbal consent to be interviewed.Results: Of the 225 participants; 83 were female; 50.7 were 20-40 years old; 56 were employed; and 53.3 were married. The majority of participants (75.1) were black Africans. About half of them (50.2) had high school education. The prevalence of topical steroid misuse for skin lightening was 35.5. A logistic regression analysis revealed that being a black female African and initially being advised to use the products by a friend were the only parameters that significantly correlated with topical steroid misuse.Conclusion: In conclusion; the prevalence of the misuse of topical steroid products among the respondents was 35.5. The following predictors were associated with topical steroid misuse: being a black female African; not being aware of the side effects of these products; and initially being advised to use the products by a friend. In a logistic regression model; the last two predictors were the only parameters that significantly correlated with topical steroid misuse. (SA Fam Pract 2006; 48(1): 14)