Browsing by Author "Rother, Andrea"

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    Aldicarb sticker (English)
    (2013) Rother, Andrea
    This sticker highlights the dangers of the street pesticide aldicarb, known as ""Two Steps"". Users mix the informally sold black powder sticks with food to kill rodents. This sticker can be used as part of training to educate aldicarb users of the dangers and alternatives.
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    Aldicarb sticker (isiXhosa)
    (2013) Rother, Andrea
    This sticker (in isiXhosa) highlights the dangers of the street pesticide aldicarb, known as ""Two Steps"". Users mix the informally sold black powder sticks with food to kill rodents. This sticker can be used as part of training to educate aldicarb users of the dangers and alternatives. This is the isiXhosa-language version of the Aldicarb sticker.
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    Assessing how South African Development Community Countries' National Adaptation Planning addresses health impacts: A scoping review
    (2023) Meyer, Renate; Rother, Andrea
    The impacts of climate variability and climate change are recognised as key challenges of the 21st century. The African continent has heightened vulnerability to the impacts of a changing climate as it is heavily reliant on agriculture for food and jobs; and experiences high levels of poverty, morbidity, situations of violence and lower levels of access to education, healthcare, nutrition and weakened social safety nets. The sub-Saharan African region is projected to have the global highest burden of disease by 2030 due to climate change. Therefore, it is key that countries have effective adaptation plans in place and that these plans are being implemented. This study reviewed available research to identify the strengths and weaknesses of the Southern African Development Community (SADC) National Adaptation Plans (NAPs) and their ability to address current and future climate change-related human health impacts. The study focused on five neighbouring countries, namely Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. Their spatial proximity afforded the opportunity to a) examine NAPs' efficacy in enabling planned implementation; b) illustrate overlaps in climate and health impacts between neighbouring countries; and c) analyse whether cross-border intergovernmental collaboration has (or could be) implemented to mitigate against and adapt to the effects of climate change on human health. Part A of the thesis presents the objectives and methods used to examine the inclusion of human health in the selected countries' NAPs. This included an extensive electronic literature search which used a combination of keywords, Medical Subject Heading (MeSH) terms and free text words. These were assessed against inclusion and exclusion criteria. Records extracted from database searches were tabled using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Review (PRISMA-ScR) template. A total of 255 records were identified in the initial screening and 10 records were included in the full text analysis. In addition, 56 identified records by other methods (namely government reports and national communications sourced from the Internet) were included in the data extraction chart, which was developed with the aim of evaluating and assessing the national strategies and plans in relation to country-specific climate and health impacts and outcomes. Based on the full text analysis, data extraction of the included studies (both from databases and other methods) was conducted. Part B of the thesis is a journal-ready article presenting the findings of the narrative scoping review. The most common climate change hazard categories and related health impacts included: an increase in temperature contributing to food and water insecurity within geographic areas; an increase in precipitation which contributed to flooding and associated with a rise in water- and vector-borne 3 diseases; temperature increase contributing to health outcomes such as heat stress, respiratory and cardiovascular disease, and violence; and an increase in emissions and air pollution with the health impacts of increased respiratory and cardiovascular diseases. The consolidated data extraction table is available on ZivaHub (Figshare for Institutions). Since sub-Saharan Africa faces immense challenges to mitigate and adapt to climate change and human health related impacts, this study assisted in identifying strengths and weaknesses of a sample of SADC NAPs. It also contributed to research on health and climate change within the SADC region, where such information is under-represented at a global level. While the evidence from the included studies is limited, this study highlights gaps in literature to encourage further research into understanding the context for national level strategies and implementation plans regarding the direct and indirect impacts of climate change on health, particularly in vulnerable groups. Part C of the thesis contains the associated appendices of both Parts A and B.
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    Assessment of Basotho women's perceptions of the health risks associated with skin-lightening in Lesotho using the Health Belief Model
    (2023) Makutoane, Ntseke; Rother, Andrea
    The practice of skin lightening has existed for centuries and is still prevalent today despite globally coordinated legal efforts to ban harmful skin-lightening agents in cosmetic items. Exposure to toxic compounds such as mercury, hydroquinone, and corticosteroids commonly found in skin-lightening products (SLPs) is associated with several adverse health risks such as adrenal disorders, hypertension, neurological problems, skin cancers, and skin atrophy. Despite the documented health risks, the practice of using highly hazardous products for skinlightening is a global public health concern that is receiving little attention. These products are commonly and freely displayed for sale on the streets and are available over the counter in many countries, including Lesotho. The SLPs were primarily intended as medical treatments for hyperpigmentation and other skin problems, but they have since gained commercial use for skin lightening. Policy interventions such as public health campaigns, research, and community-based education necessitate execution to curb skin-lightening demand and practices. Research evidence is therefore needed to inform these activities. There are currently no published studies in Lesotho highlighting why Basotho women use SLPsto inform risk reduction interventions. Hence, the need for this research. The research protocol (part A) articulates the justification and rationale of the study and describes the methodology utilized for recruitment, data collection, and analysis. It also includes a review of the literature on the history of skin lighteners, skin-lightening practice in Sub-Saharan Africa (SSA), women's motivation for skin lightening, current interventions to prohibit skin-lightening practices, and the health risks of mercury, hydroquinone, and corticosteroids in skin-lightening products. The protocol discusses ethical considerations to ensure the confidentiality of participants. The study was approved by the University of Cape Town's Health Sciences Faculty Research Ethics Committee and the Ministry of Health Ethics Clearance Committee in Lesotho. The Lesotho COVID-19 protocols were considered during the study. The journal-ready article (part B) presents the study findings on the Basotho women's attitudes of the use of SLPs, perceptions of the perceived benefits of skin-lightening, knowledge of skin-lightening health risks, and interventions that have been effective in preventing the usage and importation of SLPs in low- and middle-income countries. The study vi found that women have varying perceptions of the health risks and motivations for using SLPs. Sociodemographic factors such as age, marital status, skin tone classification, and education level had no significant role in women's decision to practice skin-lightening. Fifty-two percent of participating women, from all skin tone categories, claimed to have used SLPs. The most common motivations for using SLPs included a desire to acquire a lighter skin complexion, to remove facial blemishes, and to beautify themselves. Lack of regulations on SLPs, skin tone discrimination, and fixing the damage from overuse of SLPs were identified as perceived barriers in discouraging women from using SLPs. Regardless of whether participating women lightened their skin, about two-thirds rejected the notion that lighter skin is more attractive and increases a woman's chances of getting married. According to the study's key informants (government officials and a senior lecturer at the National University of Lesotho), the lack of national legislation on SLPs has mainly been attributed to the Lesotho Parliament's failure to domesticate the Minamata Convention on Mercury. The results of the study are intended to serve as a benchmark for future research on skin-lightening practices in Lesotho. Limitations of the study included the results' generalizability since non-randomised convenience sampling was used. Awareness-raising campaigns and the availability of legislation regulating hazardous chemicals in SLPs are needed interventions to control the usage of SLPs. The appendices (part C) provide the informed consent for women, informed consent for key informants, questionnaire for women, interview guide for key informants, ethical clearance from the University of Cape Town's Health Sciences Faculty Research Ethics Committee, ethical clearance from the Ministry of Health Ethics Clearance Committee in Lesotho, a codebook, and publishing instructions for the Environmental Health Journal.
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    Barriers to implementation of Tuberculosis infection control amongst South African Health Care Workers
    (2012) Adeleke, Oluwatoyin; Rother, Andrea; Cox, Helen
    HIV co-infection and drug resistance worsen the burden of Tuberculosis in South Africa. Infectious TB cases, often undiagnosed and untreated, are commonly found in health facilities increasing the likelihood of health-care associated TB. Health Care Workers (HCWs; and clients) are particularly at risk of TB infection in health care facilities; such risk characterises TB as a dual public health threat; first as a communicable disease and second as an occupational health hazard. Tuberculosis infection control (TBIC) measures may reduce the risk of TB transmission in health care settings, yet HCWs face challenges implementing TBIC measures. There is a gap in operational research seeking to understand the barriers to TBIC implementation among HCWs. There is, therefore, an urgent need to generate qualitative data, using a behavioural and sociological approach that provides insight to TBIC implementation challenges among HCWs. This case study research explored the barriers to TBIC implementation among HCWs in Khayelitsha clinics. Among professional and lay HCWs, data was collected by direct observation, interviews, focus group discussions and review of previous TBIC clinic assessment reports. The data was analysed using thematic analysis and interpretive analysis. This minor dissertation is in four parts. The protocol (Part A) presents the concept note of the study and its methodology. A structured literature review (Part B) provides a background and broadly reviews previous research and findings on Tuberculosis infection control. The journal ready article (Part C) presents the study findings, while Part D presents the study tools and related resources (appendices). Although most HCWs recognise the importance of TBIC in preventing health-care associated TB, they commonly believed that the TB transmission risk is only significant in clinic areas where known TB patients are found, and as such emphasise TBIC measures in those areas. Measures such as use of respirators and masks are mostly prioritized by HCWs ahead of administrative and environmental measures that are potentially more effective in reducing TB infection. Barriers to TBIC implementation identified include: inadequate HCW training on TBIC, a non-responsive compensation policy and the perception that a busy clinic schedule leaves no time for TBIC implementation. Resource availability, adequate human resources and leadership were further identified as enablers for TBIC implementation.
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    Education for sustainable healthcare: opportunities and barriers in undergraduate health professions education in South Africa
    (2025) Irlam, James; Rother, Andrea; Reid Stephen, Bruno
    The escalating global crisis of climate change and environmental degradation is having severe public health impacts. One key response requires faculties of health sciences globally to review how they prepare their health professional graduates to address the changing needs of the communities they serve. Health professions education has generally not kept pace with changing societal needs, and current curricula are often too fragmented and static to prepare graduates as effective climate health leaders and agents of change. Education for sustainable healthcare (ESH) is a field in health professions education focused on the interdependence of human health and planetary ecosystems, and on making healthcare systems more environmentally sustainable. ESH incorporates the principles of planetary health, which recognises that informed stewardship of earth's natural systems is essential for human health and well-being. ESH also includes education about environmentally sustainable healthcare, which is high-quality healthcare that is less polluting and wasteful of natural resources than conventional healthcare. There is, however, little evidence about ESH from low- and middle-income countries, which are generally most impacted by climate and environmental breakdown. The aim of this thesis was to identify the opportunities and barriers to ESH in undergraduate health professions education in South Africa, illustrated by a case study at the University of Cape Town Faculty of Health Sciences (UCT FHS). A mixed methods study of three sequential phases addressed four objectives. Phase 1 was a national survey of key educators to assess the status of ESH-related teaching and learning activities in undergraduate health professions education in South Africa. Phase 2 recruited a national Delphi panel of educators for the second objective of appraising the ESH learning objectives, activities, and assessments proposed by the International Association for Health Professions Education (AMEE) Consensus in 2021. The Delphi panel also helped achieve the third objective, to assess perceptions of educators about the opportunities and barriers to ESH in South Africa. The third phase was a Planetary Health Report Card (PHRC) assessment of the UCT FHS, by interviewing key educators and completing standardised scorecards. This phase addressed the fourth objective, to assess perceptions of educators about the opportunities and barriers to ESH in the UCT FHS. The thesis is structured into seven chapters. Chapter 1 provides the rationale, aim, objectives, design, and structure of the thesis. Chapter 2 reviews the literature on the health impacts of climate change, and the contribution of ESH towards social and environmental accountability in health professions education. It presents the conceptual framework of the thesis for evaluating environmental accountability in health professions education institutions, derived from the Conceptualisation, Production, and Usability (CPU) model for socially accountable medical schools. Chapter 3 describes the national audit survey in Phase 1, which found that ESH curriculum development is emerging in South Africa and is enabled by strong institutional leadership and by staff and student involvement. Chapter 4 analyses the findings of the national Delphi panel in Phase 2. It reached consensus on a set of learning objectives, activities, and assessments for health professions education in South Africa and identified enablers of ESH curricular development, among them faculty leaders, capable educators, and multidisciplinary collaboration. Chapter 5 presents the baseline findings of the PHRC assessment of the curricula, research, community engagement, student leadership, and campus sustainability of the UCT FHS. The PHRC identified curriculum overload, “siloed” learning, limited educator capacity, and health system challenges as key barriers, and recommended longitudinal integration of ESH across all curricula. Chapter 6 presents the discussion of the overall findings of the study. It proposes a framework for guiding ESH curricular development, which integrates recommendations in six focus areas for faculty leaders and educators within three domains of the CPU model. The key barriers and enablers of ESH identified by this study, and examples of opportunities in the UCT FHS, are also discussed. Chapter 7 concludes with the contribution of the study to knowledge about ESH and the implications for future research. The thesis has helped to build the evidence about ESH from a LMIC perspective. It has identified barriers and opportunities within South African undergraduate health professions education, and has proposed learning objectives, activities, and assessments for the South African context. A PHRC assessed opportunities for ESH integration in the UCT FHS, a first in the global South. The thesis proposes an integrated ESH curricular development framework within a social accountability model for HPE institutions, with potential applicability to low- and middle-income countries.
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    Factors influencing migrant maternal and infant nutrition in Cape Town, South Africa
    (2014) Hunter Adams, Joanne; Rother, Andrea; Myer, Landon
    Migration is a social determinant of health. The relationships between migration and health are not well understood for the large numbers of migrants in low- and middle-income countries, including South Africa. In particular, nutrition during pregnancy and the first two years of a child’s life impact infant morbidity (e.g. diarrhoea, chronic disease) and mortality, yet little is known about maternal and infant nutrition in relation to migration. Positing that migration alters the family structures that traditionally provide social support and advice for mothers, this study was framed in terms of migrants’ loss of these social supports in Cape Town. This framing provided context for the broader investigation of migrants’ nutrition during pregnancy and the first two years of their infants’ lives. This qualitative study with migrants from the Democratic Republic of Congo (DRC), Somalia, and Zimbabwe included 23 in-depth interviews with recently (<2 years) postpartum women, and nine focus groups with adult men (N=3; n=21) and women (N=6; n=27). While in-depth interviews provided insights into individual nutritional motivations, focus groups provided insights into the social context of nutrition. Language interpretation was used in cases where participants did not speak English. Interviews and focus groups were recorded and transcribed verbatim; bilingual research assistants checked the quality of language interpretation and transcription. Rooted in notions of social constructivism, thematic analysis guided the development of a codebook of themes and subthemes. These analytic themes were grouped in relation to (1) maternal nutrition, (2) infant nutrition, and (3) past and present social support. Thereafter, a “thick description” involved interpreting key themes and producing the narrative that integrated focus group data and in-depth interview data. Analysis of maternal nutrition involved documenting foods consumed during pregnancy, as well as investigating the motivations that undergird nutrition during this period. The findings related to migrant maternal nutrition affirmed and built on previous research, which suggested that pregnant women generally maintained their previous non-pregnant eating habits. While cravings were dominated by self-perceived “traditional” foods of home, that were expensive and hard to find in Cape Town, women also commonly described consumption of fast foods and junk foods during pregnancy. Participants did not mention food scarcity, despite the fact that some migrants appeared to be food insecure. These findings illuminated the role of the nutrition transition in Cape Town, that is, migrants were at risk of consuming energy-dense, nutrient-poor diets, particularly during pregnancy. Secondly, analysis of participants’ experience of breastfeeding, formula feeding, and complementary feeding took place in the context of high rates of breastfeeding initiation but low rates of exclusive breastfeeding in many parts of Africa, including migrants’ countries of origin. In this study, migrants presented the common decision to introduce formula in light of their experiences of Cape Town as a work environment. Participants framed the introduction of formula and complementary food early in an infant’s life as primarily a pragmatic and intuitive decision in response to their infant’s cues. Whereas past studies conducted in LMIC tend to present breastfeeding as an important intervention to improve child “survival”, participants in this study were not primarily concerned with child survival. Rather, they were concerned with their family’s tenuous circumstances in Cape Town. As such, efforts by the health system to promote breastfeeding amongst migrants should emphasize benefits to long-term health as well as the short-term financial costs of formula feeding. However, I argue that this shift cannot occur without recognition of, and attention to, migrants’ pressing short-term needs, including housing, legal work status, and safety. Another important factor influencing maternal and infant nutrition revolved around the loss of social support, particularly the loss of the elder generation. Elder women played a central role in providing physical, social and informational support to new mothers in migrants’ countries of origin. As such, the absence of grandmothers in migrant communities in Cape Town was central to understanding participants’ maternal and infant nutrition decisions. Yet participants focused on the loss of household help, including cooking, rather than on grandmothers’ traditional authority or nutritional advice. Given the relative absence of the older, nonworking, generation in Cape Town, community support was limited by the pressures of work and survival. These pressures seemed to make healthy nutrition during pregnancy, or exclusive breastfeeding very difficult. Given this lack of support, medical providers presented one avenue of additional support. However, migrants were frequently unable to communicate with health care providers, and felt discriminated against and unwelcome in the health care system. The three primary findings relating migration and maternal and infant nutrition in Cape Town suggest several avenues for intervention and further study. Firstly, migrants’ descriptions of energy-dense, nutrient-poor diets suggest a role of policy-makers to improve the overall accessibility, availability, and affordability of more nutritious food to the poor in Cape Town. Recognising that foods from migrants’ countries of origin were of particular cultural and nutritional value, a smaller scale intervention might involve creating space and time for the preparation of “traditional” foods. Secondly, improving infant feeding involves re-orientating migrants towards the long-term benefits of breastfeeding and complementary feeding, and engaging spouses and male partners as integral to this process. Further research is needed to create a strong evidence base for the increasing rates of breastfeeding, both in Cape Town and in other urban centres in LMIC. Thirdly, given self-described social isolation and poor experiences in healthcare settings, free-to-patient medical interpretation may play an important role in connecting migrants to both healthcare services as well as broader social services. The improved communication facilitated by medical interpretation may also play a role in combatting the xenophobia that migrants face, both in the healthcare setting as well as in daily life. Indeed, my recommendations must be part of a broader public health research effort to explicate the negative health consequences of xenophobia. To design appropriate research and interventions for migrants, it is important to acknowledge the overarching roles played by xenophobia, legal status, and the broader socio-economic context in shaping maternal and infant nutrition
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    Globally Harmonized System (GHS) symbols and meanings
    (2013) Rother, Andrea
    The Globally Harmonized System of Classification & Labelling of Chemicals (GHS) is a system with the objective of harmonizing information on labels & SDSs. This card can be used as part of training on the Globally Harmonized System (GHS) symbols and meanings.
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    Improving notification of pesticide poisonings
    (2013) Rother, Andrea
    This document is intended to assist health care professionals, environmental health practitioners and health promoters in identifying the pesticide involved in suspected pesticide poisoning cases so as to improve notification. This point chart can be distributed to health care professionals, environmental health practitioners and health promoters to assist them in providing correct and complete information when notifying the Department of Health of pesticide poisonings.
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    Pesticide label card (Afrikaans)
    (2013) Rother, Andrea
    Ths is a card (in Afrikaans) to educate pesticide users about the meanings of commonly used pictograms and symbols, which are often misinterpreted and not understood. This card can be used as part of training to educate pesticide users about the meanings of commonly used pictograms and symbols.
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    Pesticide label card (English)
    (2013) Rother, Andrea
    This is a card to educate pesticide users about the meanings of commonly used pictograms, colour codes and symbols, which are often misinterpreted and not understood. This card can be used as part of training to educate pesticide users about the meanings of commonly used pictograms and symbols.
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    Pesticide label card (French)
    (2013) Rother, Andrea
    This is a card (in French) to educate pesticide users about the meanings of commonly used pictograms and symbols, which are often misinterpreted and not understood. This card can be used as part of training to educate pesticide users about the meanings of commonly used pictograms and symbols.
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    Pesticides Health and Safety posters
    (2014-09-29) Rother, Andrea; London, Leslie; Miller, Eric
    These posters are available at no cost to help train farmers; farmworkers; farmworker families; pesticide mixers, loaders and applicators; health providers; and other members of the agricultural community about pesticide health and safety issues. The posters can be used by farmers and non-governmental organisations or government departments working with farmers and farmworkers; in the area of workers’ rights and occupational health and safety; or in urban areas where domestic pesticide use is prevalent. Go to Pesticides Health and Safety posters The posters available here pertain to the safe use of agricultural and domestic pesticides. The posters provide an overview of several themes related to pesticides health and safety, namely: • How to store pesticides safely • How to prevent exposure and poisoning among children • What to do if someone becomes sick after spraying pesticides • How to wear personal protective equipment (PPE) • How to mix pesticides safely • The main hazards of pesticides and how to prevent pesticide poisoning • How to dispose of pesticide containers • How to read pesticide labels • Colour codes
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    Prevalences of mental health disorders among low- and lower middle-income countries' children and adolescents exposed to extreme weather events: a systematic review and meta-analysis
    (2025) Choi, Munkyung Elizabeth; Rother, Andrea; Engel, Mark
    Background: Research concerning the disproportionate health consequences of climate change is still unexplored, specifically in one of the most vulnerable populations: children and adolescents living in low- and lower middle-income countries (LLMICs). At present, there is a gap in current literature on how prevalent LLMIC youth mental health burdens are following climate-induced extreme weather events (EWEs). This systematic review serves to uncover these mental health burdens in response to the EWEs projected to intensify in the near future. Methods: The Context Condition Population (CoCoPop) framework for prevalence studies was used to identify eligible studies. Mental health disorders were the condition of interest, in the context of LLMICs under the population of children and adolescents (1 to 19 years of age) who had experienced at least one EWE. MEDLINE via PubMed, PsychINFO, Web of Science Core Collection, Scopus, and CINAHL were databases retrieved using the search strategy. All searches were done in June 2024. Two researchers screened and three extracted the data. Meta-analyses were conducted using R (4.2.3). Results: Twenty-seven studies met the eligibility criteria with a total sample population of 14239 participants. The most prevalently reported mental health disorders identified were anxiety (32.7% 95% CI: 7.1-65.6), depression (33.2% 95% CI: 17.0-51.8), and post-traumatic stress disorder (PTSD) (50.4% 95% CI: 36.7-64.1). Heterogeneity as high in all groups (I² = >90%). Subgroup analyses were conducted, grouped by type of EWE, age, region, time-point measured, and measurement tool standardization. Conclusions: This review provides critical insights into the mental health burdens LLMIC youth face after experiencing EWEs. Anxiety, depression, and PTSD are commonly found prevalent, influenced by factors such as the type of EWE, age, region, different time points measured, and measurement tools' standardization. The high heterogeneity observed across studies highlights the challenges in standardizing mental health measurements, especially in LLMIC settings. Influential factors must be considered to fully comprehend and address the complexities of the vulnerable group's mental health states. LLMIC stakeholders must not only acknowledge mental health disorder repercussions from EWE exposures but also translate such evidence into palpable interventions.
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    Retrospective analysis of suspected pesticide-related fatalities admitted to Salt River Mortuary in the West Metropole of Cape Town, Republic of South Africa
    (2018) Patience, Meryl; Davies, Bronwen; Rother, Andrea
    Introduction: Pesticides offer great benefits in the agricultural sector, but exposure may pose both acute and chronic health risks to humans. In developing countries, morbidity and mortality rates related to pesticide exposure are high and in certain areas (such as in rural, lower socioeconomic and/or agricultural-dependent communities), pesticides may be stored in and around homes, which may increase the risk of accidental exposure as well as intentional poisoning. In Cape Town, South Africa, this public health issue is exacerbated by the informal selling of street pesticides. These are pesticides that usually comprise of a mixture of these chemicals, sold unregistered as liquids or granules in bottles or packages without clear identification labels, for domestic use. While cheap and widely available in informal settlements; these pesticide formulations are not regulated and extremely toxic. Data illustrating the extent and nature of fatalities related to acute and chronic pesticide exposure in Cape Town, particularly as related to street pesticides, is limited. This dissertation provides an overview of the literature associated with pesticide toxicity and related mortality, paying particular attention to available South African research. This is followed by a study investigating pesticide deaths at Salt-River Mortuary over a period of five years. Aim: The aim of this study was to determine the prevalence and characteristics of deaths associated with suspected acute pesticide toxicity, to broaden the spectrum of knowledge concerning pesticide-related deaths in Cape Town, South Africa. Methods: A retrospective analysis of cases admitted to Salt River Mortuary (SRM) from 2011 to 2015 (inclusive) was conducted. Demographic, autopsy, investigative and toxicological data (where available) were collected from post-mortem and other investigative reports. Results: Of the total of 16,453 cases admitted to SRM over a five-year period from January 2011 until December 2015, 104 (0.63%) were deemed to be acutely pesticide-related based on available autopsy data. There was an equal number of male (n=52; 50%) and female (n=52; 50%) victims. Most deaths (n=74; 71%) occurred at medical centres following exposure, and Terbufos was found to be the common pesticide detected analytically (n=42, 61%) in toxicology reports available (76%). Results revealed that (60%) of acute pesticide toxicity cases were suspected suicides, while (6%) of cases were suspected accidents and (3%) cases were suspected homicides, while the remainder were still undetermined pending toxicological investigations. Conclusion: A history of ingestion, autopsy findings and toxicological results (if available) assisted in identification of these cases, most of which came from lower socio-economic communities. While the number of overall cases is low, it is evident that these deaths are a public health burden, and may be preventable through improved notification and policy development. Challenges with this study involved the inability to distinguish mortality associated with chronic pesticide exposure, the lack of toxicological results available, limited scene investigation information to identify street pesticide contributions, and that the study was limited to one mortuary in Western Cape. An extension of this research to other mortuaries in Western Cape as well as collaborative work with community and public health sectors on availability and toxicity of street pesticides will assist in strategic intervention methods and policy reform to reduce accidental and suicidal mortality associated with acute pesticide exposure.