When is it herbal intoxication? A retrospective study of children admitted with herbal intoxication at Umtata General Hospital, South Africa.

Objective: To establish the profile and fate of children admitted with a "herbal intoxication" label.

Design: Retrospective cross sectional study of records for all children admitted with "herbal intoxication" for the years 1998 to 2001 inclusive.

Setting: The Paediatrics Department at Umtata General Hospital, the main teaching hospital for the University of Transkei Faculty of Health Sciences.

Main Outcome Measures: Demographic profile, herbal medication history and clinical progress and fate of children admitted with "herbal intoxication".

Results: There were 156 case records for the period under review. The age range was a few days to 12 years, being neonates 30 (19.2%); one to six months, 77 (49.4%); seven months to one year 34 (21.8%); one to five years, 11 (7.0%); five years and older, four (2.6%). The reasons for giving the herbal preparations were stated in only 52 cases (33.3%), of which five were for diarrhoea and vomiting, four for constipation and abdominal pain, three to change stool colour, and 41 for "playte" (generic term given to all types of ill health). The preparations were administered orally (n=95), by enema (n=12), and both orally and by enema (n= 12), while route of administration was not stated in 37 of the cases. Sixty eight (43.6%) of the children died, 84 (53.8%) improved, while the fate of four (2.6%) was not indicated. Most of the deaths (63.2%) were among the zero to six months age group, and most deaths occurred within two days of admission. The average duration of stay (days) in hospital was 2.94 +/- 0.65 (range 1 to 39) for the group that succumbed and 8.88 +/- 0.73 (range 1 to 40) for the survivors (p < 0.001).

Conclusion: There is a high mortality rate among children admitted with suspicion of herbal intoxication, and there is need to manage such children with vigilance.