The prevalence of liquid chromatography-tandem mass spectrometry-confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

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 152 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.

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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 ◽

10.1186/s12887-021-02500-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Norbertta Washaya ◽

Alicia Evans ◽

Rudzani Muloiwa ◽

Peter Smith ◽

Heloise Buys

Keyword(s):

Mass Spectrometry ◽

South Africa ◽

Liquid Chromatography ◽

Tandem Mass Spectrometry ◽

Red Cross ◽

Tandem Mass ◽

Social Interventions ◽

Chromatography Tandem Mass Spectrometry ◽

Unknown Substance ◽

Liquid Chromatography Tandem Mass

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.

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A prospective study to assess the value of liquid chromatography-tandem mass spectrometry in the management of paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

10.21203/rs.3.rs-41167/v1 ◽

2020 ◽

Author(s):

Norbertta Washaya ◽

Alicia Evans ◽

Rudzani Muloiwa ◽

Peter Smith ◽

Heloise Buys

Keyword(s):

Mass Spectrometry ◽

South Africa ◽

Liquid Chromatography ◽

Tandem Mass Spectrometry ◽

Red Cross ◽

Tandem Mass ◽

Children's Hospital ◽

Social Interventions ◽

Chromatography Tandem Mass Spectrometry ◽

Liquid Chromatography Tandem Mass

Abstract Introduction 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.ObjectiveThe study describes the prevalence of LC-MS/MS diagnosed poisoning and the management of paediatric poisoning at Red Cross Children’s Hospital, South Africa.MethodsChildren 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.Results152 children, with median age of 39 (IQR 25 -61) months were enrolled of whom 128 (84%) were poisoning cases. Of the 128 poisoning cases, 88 (69%) presented with a history of a known toxin, 16(12%) an unknown toxin and 24(19%) were cases of occult poisoning. LC-MS/MS was able to identify a toxin in 92% of the cases of occult poisoning. In those who had presented with a seemingly known toxin, LC-MS/MS found a different toxin in 15 cases. LC-MS/MS was also able to detect multiple drugs in 40 patients. Of the poisoning cases, 6% were attempted homicide cases and 5% attempted suicide cases. No children died. Individualized social interventions were instituted in poisoning cases. Emergency placement for safety reasons was required in 6 children.ConclusionLC-MS/MS is useful in identifying cases of occult poisoning; identifying patients who have ingested multiple toxins 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.

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The prevalence of liquid chromatography-tandem mass spectrometry-confirmed paediatric poisoning at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa

10.21203/rs.3.rs-45295/v2 ◽

2021 ◽

Author(s):

Norbertta Washaya ◽

Alicia Evans ◽

Rudzani Muloiwa ◽

Peter Smith ◽

Heloise Buys

Keyword(s):

Mass Spectrometry ◽

Liquid Chromatography ◽

Tandem Mass Spectrometry ◽

Cape Town ◽

Red Cross ◽

Tandem Mass ◽

Social Interventions ◽

Chromatography Tandem Mass Spectrometry ◽

Unknown Substance ◽

Liquid Chromatography Tandem Mass

Abstract BackgroundPaediatric 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.ObjectiveThe 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.MethodsChildren 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. Results152 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.

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