The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa
| dc.contributor.author | Washaya, Norbertta | |
| dc.contributor.author | Evans, Alicia | |
| dc.contributor.author | Muloiwa, Rudzani | |
| dc.contributor.author | Smith, Peter | |
| dc.contributor.author | Buys, Heloise | |
| dc.date.accessioned | 2021-10-12T07:33:02Z | |
| dc.date.available | 2021-10-12T07:33:02Z | |
| dc.date.issued | 2021-01-18 | |
| dc.date.updated | 2021-01-24T04:33:10Z | |
| dc.description.abstract | Background Paediatric poisoning is a common presentation to emergency departments worldwide. There is a paucity of data on the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS), in the management of paediatric poisoning in low-and middle-income countries (LMICs). In high-income countries, most studies are retrospective, and few include children. Objective The study describes the prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods Children admitted with suspected poisoning between 1 January 2017 and 31 December 2017, were recruited. All patients had a urine and/or blood sample sent for LC-MS/MS toxicology. Data collected included demographic data, clinical features, investigations, management, outcome and social interventions. Results One hundred fifty-two children, with median age of 39 (IQR 25–61) months were enrolled of which 128 (84%) were poisoning cases. Of the 128 poisoning cases, 88 (69%) presented with a history of ingesting a known substance, 16 (12%) an unknown substance and 24 (19%) were cases of occult poisoning. LC-MS/MS was able to identify a substance in 92% of the cases of occult poisoning. In those who had presented with a seemingly known substance, LC-MS/MS found a different substance in 15 cases. LC-MS/MS was also able to detect multiple drugs in 40 patients. Of the poisoning cases, six (5%) cases were attempted homicide cases and 5 (4%) cases were attempted suicide cases. No children died. Individualized social interventions were instituted in poisoning cases. Emergency placement safety reasons was required in 6 children. Conclusion When the limitations are known, LC-MS/MS is useful in identifying cases of occult poisoning, identifying patients who have ingested multiple substances and/or an unknown substance and when targeted towards child protection. As LC-MS/MS is an expensive test, it should be used judiciously in LMICs. | en_US |
| dc.identifier.apacitation | Washaya, N., Evans, A., Muloiwa, R., Smith, P., & Buys, H. (2021). The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. <i>BMC Pediatrics</i>, 21(Article number: 42), http://hdl.handle.net/11427/35183 | en_ZA |
| dc.identifier.chicagocitation | Washaya, Norbertta, Alicia Evans, Rudzani Muloiwa, Peter Smith, and Heloise Buys "The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa." <i>BMC Pediatrics</i> 21, Article number: 42. (2021) http://hdl.handle.net/11427/35183 | en_ZA |
| dc.identifier.citation | Washaya, N., Evans, A., Muloiwa, R., Smith, P. & Buys, H. 2021. The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. <i>BMC Pediatrics.</i> 21(Article number: 42) http://hdl.handle.net/11427/35183 | en_ZA |
| dc.identifier.ris | TY - Journal Article AU - Washaya, Norbertta AU - Evans, Alicia AU - Muloiwa, Rudzani AU - Smith, Peter AU - Buys, Heloise AB - Background Paediatric poisoning is a common presentation to emergency departments worldwide. There is a paucity of data on the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS), in the management of paediatric poisoning in low-and middle-income countries (LMICs). In high-income countries, most studies are retrospective, and few include children. Objective The study describes the prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. Methods Children admitted with suspected poisoning between 1 January 2017 and 31 December 2017, were recruited. All patients had a urine and/or blood sample sent for LC-MS/MS toxicology. Data collected included demographic data, clinical features, investigations, management, outcome and social interventions. Results One hundred fifty-two children, with median age of 39 (IQR 25–61) months were enrolled of which 128 (84%) were poisoning cases. Of the 128 poisoning cases, 88 (69%) presented with a history of ingesting a known substance, 16 (12%) an unknown substance and 24 (19%) were cases of occult poisoning. LC-MS/MS was able to identify a substance in 92% of the cases of occult poisoning. In those who had presented with a seemingly known substance, LC-MS/MS found a different substance in 15 cases. LC-MS/MS was also able to detect multiple drugs in 40 patients. Of the poisoning cases, six (5%) cases were attempted homicide cases and 5 (4%) cases were attempted suicide cases. No children died. Individualized social interventions were instituted in poisoning cases. Emergency placement safety reasons was required in 6 children. Conclusion When the limitations are known, LC-MS/MS is useful in identifying cases of occult poisoning, identifying patients who have ingested multiple substances and/or an unknown substance and when targeted towards child protection. As LC-MS/MS is an expensive test, it should be used judiciously in LMICs. DA - 2021-01-18 DB - OpenUCT DP - University of Cape Town IS - Article number: 42 J1 - BMC Pediatrics KW - Poisoning KW - Africa KW - Children KW - Mass spectrometry KW - LC-MS/MS toxicology results in poisoning cases LK - https://open.uct.ac.za PY - 2021 T1 - The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa TI - The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa UR - http://hdl.handle.net/11427/35183 ER - | en_ZA |
| dc.identifier.uri | https://doi.org/10.1186/s12887-021-02500-x | |
| dc.identifier.uri | http://hdl.handle.net/11427/35183 | |
| dc.identifier.vancouvercitation | Washaya N, Evans A, Muloiwa R, Smith P, Buys H. The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa. BMC Pediatrics. 2021;21(Article number: 42) http://hdl.handle.net/11427/35183. | en_ZA |
| dc.language.iso | en | en_US |
| dc.language.rfc3066 | en | |
| dc.publisher.department | Department of Paediatrics and Child Health | en_US |
| dc.publisher.faculty | Faculty of Health Sciences | en_US |
| dc.rights.holder | The Author(s) | |
| dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
| dc.source | BMC Pediatrics | en_US |
| dc.source.journalissue | Article number: 42 | en_US |
| dc.source.journalvolume | 21 | en_US |
| dc.source.uri | https://bmcpediatr.biomedcentral.com/ | |
| dc.subject | Poisoning | en_US |
| dc.subject | Africa | en_US |
| dc.subject | Children | en_US |
| dc.subject | Mass spectrometry | en_US |
| dc.subject | LC-MS/MS toxicology results in poisoning cases | en_US |
| dc.title | The prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa | en_US |
| dc.type | Journal Article | en_US |