Streamlining referral decisions for childhood poisoning: a cross-sectional study from a tertiary children's hospital in Cape Town, South Africa.

Introduction: The study objectives were to report on current paediatric poisoning figures from South Africa, and to better understand this patient population to contribute suggestions for streamlining local triage and referral criteria.

Methods: A retrospective review of children presenting to Red Cross War Memorial Children's Hospital (RCWMCH) with poisoning between January 2009 and December 2019 was performed. Data were extracted from the Poisons Information Centre's Clinical Poisonings Database.

Ivermectin exposures reported to the Poisons Information Helpline in South Africa during the COVID-19 pandemic.

Background: Ivermectin is an antiparasitic drug that has shown in vitro activity against COVID‑19. Clinical studies supporting ivermectin for COVID‑19 prevention and treatment are conflicting, with important limitations. Public support for ivermectin is significant, with extensive off-label use despite the conflicting views on its efficacy.

Prolonged paralysis in a child with organophosphate pesticide poisoning.

A 17-month-old boy presented to a local community health centre in Cape Town, South Africa, with severe organophosphate pesticide poisoning (OPP), necessitating the use of intravenous atropine to control cholinergic symptoms, as well as emergency intubation for ongoing respiratory distress. He required prolonged ventilatory support in the intensive care unit at his referral hospital and had subsequent delayed neurological recovery, spending 8 days in hospital.We present this case to emphasise the importance of adequate atropinisation in the management of severe OPP and to highlight the dangers of inappropriate use of suxamethonium for intubation in patients with OPP.

The efficacy of prophylactic antibiotics in the management of children with kerosene-associated pneumonitis: a double-blind randomised controlled trial.

Context: Hydrocarbons, especially kerosene (paraffin), are the most common agents causing childhood poisoning in low and middle income countries (LMICs). Aspiration of kerosene causes an inflammatory sterile chemical pneumonitis, which may increase susceptibility to secondary lower respiratory tract bacterial infection. This study aimed to assess the efficacy of prophylactic antibiotics in the management of kerosene-associated pneumonitis in children and to identify risk factors associated with severity or outcome.