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

Mbongwe, Bontle and Moinami, Jacqueline and Masupe, Tiny and Tapera, Roy and Molefe, Tshenkego and Erick, Patience and Godman, Brian and Massele, Amos (2020) Nature and sources of poisoning in patients admitted to a referral hospital in Gaborone, Botswana : findings and implications. Hospital Practice, 48 (2). pp. 100-107. ISSN 2377-1003 (https://doi.org/10.1080/21548331.2020.1739415)

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Abstract

Background: Intentional poisoning is becoming an important public health concern particularly among young women globally. Consequently, there is a need to analyse 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.