Acute poisonings presenting to King Edward VIII hospital intensive care unit in Durban, South Africa

Abstract

Acute poisoning represents a complex public health problem, resulting in hospitalisation, utilisation of healthcare resources and mortality.[1] According to the World Health Organization (WHO), ~800 000 people die of suicide annually and it is estimated that around 20% of global suicides are due to pesticide self-poisoning, most of which occur in rural agricultural areas in developing countries.[2] Studies have determined a high rate of poisoning in Gauteng and Eastern Cape provinces[3,4] but no data are available for poisonings in the critical care setting in KwaZulu-Natal (KZN) Province, which is South Africa’s (SA’s) second most populated province after Gauteng.[4,5] Poisoning represents an avoidable burden on limited critical care resources in SA. In the Eastern Cape, 15 20% of patients presenting with acute poisonings were admitted to a critical care unit, further straining the healthcare sector in one of SA’s poorest provinces.[4] The profile of patients and the type of toxins ingested varies between countries and between urban and rural settings. The risk factors for poisoning include systemic illnesses, psychiatric disorders, drug and alcohol abuse, interpersonal difficulties and socioeconomic problems.[7] In the SA context, agricultural chemicals accounted for 20% of deaths in eight hospitals in Gauteng and KZN provinces.[8,9] The King Edward VIII Hospital (KEH) ICU is a busy multidisciplinary unit in a tertiary, academic hospital in Durban, SA. Although situated in a major metropolitan area, the ICU provides critical care for patients from urban, peri-urban and rural areas throughout KZN. There is limited information regarding the poisoning patterns and critical care outcomes in this setting. The aim of the present study was to describe the demographics, clinical features, course and outcomes of all patients presenting with acute poisonings at the study ICU over a 24-month period. Acute poisonings presenting to King Edward VIII hospital intensive care unit in Durban, South Africa