Contribution of plants and traditional medicines to the disparities and similarities in acute poisoning incidents in Botswana, South Africa and Uganda

Factors and Practices Associated with Self-Medicating Children among Mexican Parents

Background: Pediatric self-medication is based on the subjective interpretation of symptoms in children by the mother or an adult, the decision to self-medicate is made by a third party. The objective of this work is to provide information on the factors and practices associated with the self-medication of children among parents in Mexico. Methods: A cross-sectional and descriptive study was conducted between June 2020 and December 2021 on Mexican parents with children under 12 years of age. Online questionnaires were completed with sections on sociodemographic characteristics, use of medicines or medicinal plants and their treated symptoms, sources of collection, and their recommendation. Results: A total of 9905 online surveys were completed with representation from the 32 states of Mexico, and the prevalence of self-medication was 49.6% (n = 4908). Associated factors were age, having two or more children, children with chronic illnesses, medium educational level, unemployment or employment unrelated to health, medium and high socioeconomic level, and lack of medical security. Respondents self-medicated their children on the recommendation of a family member or friend (55.8%), and own initiative (28%). The most used medication was VapoRub (61.3%), followed by paracetamol (56.9%) and chamomile (33.1%), and the most prevalent symptoms were flu/flow (47.7%) followed by cough (34.2%). The main reasons were perceiving symptoms as not serious (69.9%) and reusing medications (51.9%). Conclusions: There is a high prevalence of self-medication in children in Mexico, mainly associated with children with chronic diseases and families with three or more children.

Treatment outcome and associated factors among patients admitted with acute poisoning in a tertiary hospital in Eastern Ethiopia: A cross-sectional study

Introduction:

Acute poisoning causes morbidity and mortality worldwide. There is scarce of information on acute poisoning in the study area.

Objective:

To assess treatment outcome and the associated factors among patients admitted with acute poisoning at Hiwot Fana Comprehensive Specialized Hospital, Eastern Ethiopia.

Methods:

A cross-sectional study was conducted. All acutely poisoned patients who had been admitted at the emergency department of Hiwot Fana Comprehensive Specialized Hospital from 1 January 2016 to 31 December 2020 who fulfilled the inclusion criteria of the study were included. Data were collected by review of medical records. Poor treatment outcome of acute poisoning was defined as the acutely poisoned patient was died, or survived with disability. Multivariate logistic regression analysis was used to determine factors associated with the outcome of acute poisoning.

Result:

A total of 175 patient’s medical records were reviewed. Of these, 150 patient’s medical records had complete information and were included in the final analysis. The majority of participants 89 (59.3%) were in the age group of 19–37 years. More than half of the participants 86 (57.3%) were females. Organophosphate was the most poisoning agent encountered in 62 cases. Acetaminophen was the predominant drug poisoning agent encountered in 10 participants. Among 30 patients managed with antidote, 18 patients were treated with atropine for organophosphate poisoning. Of all the poisoning cases admitted during the study period, 16.7% died. Participants who were poisoned by themselves were 2.4 times more likely to have poor treatment outcomes than those who were poisoned accidentally: 2.44 (95% confidence interval: 1.10–5.42). The odd of having poor treatment outcome in participants who were poisoned by drugs was 2.13 more likely: 2.13 (95% confidence interval: 1.21–3.32).

Conclusion:

Organophosphate was the predominant cause of acute poisoning encountered in 62 cases. The modes of poisoning and drug poisoning were significant risk factors associated with poor treatment outcomes of acute poisoning.

Nature and sources of poisoning in patients admitted to a referral hospital in Gaborone, Botswana; findings and implications

BACKGROUND

Intentional poisoning is becoming an important public health concern particularly among young women globally. Consequently, there is a need to analyze this further within countries to establish pertinent policies to reduce current incidence rates. This includes sub-Saharan African countries where there has been a scarcity of information. Consequently, we sought to establish the nature and sources of poisoning in patients admitted to a leading hospital in Botswana to help develop pertinent future policies for Botswana and surrounding countries.

METHODS

Retrospectively reviewing the medical records of all patients admitted to Princess Marina Hospital (PMH), which is a leading tertiary hospital in the capital city of Botswana, due to acute poisoning over a six-year period.

RESULTS

The records for 408 patients were reviewed. The majority of admissions (58%) were females, and the mean age of patients was 21(±14) years. Most poisoning cases (53%) were intentional. The 15-45 years age group was most likely to intentionally poison themselves compared to other age groups, with females four and half times more likely to intentionally poison themselves compared to males (AOR 4.53, 95% CI: 2.68-7.89, p < 0.001). Half of the patients were poisoned by medicines followed by household chemicals (22%), with females overall four times more likely to be poisoned by medicines compared to males. The medicine mostly ingested was paracetamol (30%). Failing relationships (57%) were the principal reason for intentional poisoning. Six patients died from poisoning representing a 1.5% mortality rate.

CONCLUSIONS

The findings suggest in-depth and urgent investigations on intentional poisoning are needed among young women across countries including sub-Saharan African countries to inform future policies on prevention strategies. Further, strategies for poisoning prevention should target social and family relationship problems. We will be following this up in the future.

Occurrence of bacteria and endotoxins in fermented foods and beverages from Nigeria and South Africa

In Africa, fermented foods and beverages play significant roles in contributing to food security. Endotoxins are ubiquitous heat stable lipopolysaccharide (LPS) complexes situated in the outer cell membranes of Gram-negative bacteria. This study evaluated the microbiological quality of fermented foods (ogiri, ugba, iru, ogi and ogi baba) and beverages (mahewu and umqombothi) from selected Nigerian and South African markets. The bacterial diversity of the fermented foods was also investigated and the identity of the isolates confirmed by biochemical and molecular methods. Isolate grouping was established through hierarchal clustering and the samples were further investigated for endotoxin production with the chromogenic Limulus Amoebocyte Lysate assay. The total aerobic count of the samples ranged from 5.7 to 10.8 Log CFU/g. Fourteen bacteria genera were detected with most of the isolates being members of the Enterobacteriaceae family. Sphingomonas paucimobilis and Escherichia coli were the dominant Gram-negative bacterial species detected. There were considerable variations in the concentrations of endotoxins produced and the lowest endotoxin concentration was found in ogi (4.3 × 10 EU/g) and the highest in iru (5.5 × 10⁴ EU/g) while, 44% of umqombothi samples had endotoxins. Ogi baba samples had better microbial quality than other samples due to its reduced bacterial load and endotoxin levels. There was a strong positive (r = 0.714, r = 0.996) and significant (p < 0.01) correlation between the endotoxin levels and bacterial loads of the samples. Some previously unreported species of bacteria found in the fermented foods included Aeromonas haemolyticus and Rhizobium radiobacter. This is the first comprehensive report on endotoxins in fermented foods and beverages in Africa. Furthermore, the occurrence of pathogenic bacteria and toxins in the foods and beverages is of serious concern that calls for immediate action.

Plant toxins and acute medicinal plant poisoning in children: A systematic literature review

BACKGROUND

For many years, medicinal plants and herbal therapy have been widely used in different societies for the treatment of various diseases. Besides their therapeutic potency, some of the medicinal plants have strong toxicity in human, especially in children and elderly. Despite common beliefs that natural products are safe, there have been few reports on their toxicities.

MATERIALS AND METHODS

In the present study, we aimed to systematically review the literature wherein acute plant poisoning and herbal intoxication have been reported in pediatric patients. After literature search and selection of the appropriate documents, the desired data were extracted and described qualitatively.

RESULTS

A total of 127 articles with overall 1453 intoxicated cases were collected. The results of this study showed that some medicinal plants can cause acute poisoning and complications such as hepatic and renal failure in children.

CONCLUSION

The findings of this survey showed that acute plant poisoning can be life?threatening in children, and since a single?ingested dose of toxic plants can cause acute poisoning, parents should be aware of these toxic effects and compare the side effects of self?medication with its potential benefits.

Characteristics of Pesticide Poisoning in Rural and Urban Settings in Uganda

Pesticide poisoning is a significant burden on health care systems in many low-income countries. This study evaluates cases of registered pesticide poisonings treated in selected rural (N = 101) and urban (N = 212) health facilities in Uganda from January 2010 to August 2016. In the urban setting, pesticides were the most prevalent single poison responsible for intoxications (N = 212 [28.8%]). Self-harm constituted a significantly higher proportion of the total number of poisonings in urban (63.3%) compared with rural areas (25.6%) where unintentional poisonings prevailed. Men were older than women and represented a majority of around 60% of the cases in both the urban and rural settings. Unintentional cases were almost the only ones seen below the age of 10, whereas self-harm dominated among adolescents and young persons from 10 to 29 years of age. Organophosphorus insecticides accounted for 73.0% of the poisonings. Urban hospitals provided a more intensive treatment and had registered fever complications than rural health care settings. To minimize self-harm with pesticides, a restriction of pesticide availability as shown to be effective in other low-income countries is recommended. Training of health care workers in proper diagnosis and treatment of poisonings and improved equipment in the health care settings should be strengthened.