Paraffin (kerosene) poisoning in childhood--is prevention affordable in South Africa?

Paraffin (known in some Western countries as kerosene) ingestion is the most common form of acute childhood poisoning in most developing countries. South African black communities reflect a similar pattern, yet the true size and cost of the problem are not known. Without such baseline data the effect of interventions cannot be evaluated. The aim of the study was to determine the incidence and treatment cost of paraffin poisoning in the Cape Peninsula, to identify high-risk areas and to discuss which measures offered the most economical and best preventive potential for this paediatric hazard. A 12-month retrospective study was undertaken in 1990. Relevant patient data were extracted from the files of 6 major Cape Peninsula hospitals. Treatment costs were calculated based on differential hospital costs per inpatient per day, with outpatient costs at one-third of the costs per day. Age-specific rates for affected residential areas were calculated to identify high-risk areas. A total of 436 children (62,5% male), mostly between the ages of 12 and 36 months, were treated at an estimated cost of R111 673. This amount would have been sufficient to provide 95% of households in the 8 identified high-risk areas with child-resistant paraffin containers. In these areas age-specific paraffin poisoning rates ranged from 1,8/1,000 to 7,7/1,000. Strategically planned interventions can be cost-effective when weighed against the treatment cost of cases of paraffin poisoning.