South African Marine Envenomations and Poisonings as Managed Telephonically by the Tygerberg Poisons Information Centre: A 20-Year Retrospective Review

Abstract

South Africa has an abundance of marine life, and the potential for hazardous exposure to marine life is high. To our knowledge, this is the first epidemiological review regarding marine toxicity that has ever been conducted in sub-Saharan Africa. The aim of this review was to investigate marine toxicology data as managed telephonically by the Tygerberg Poisons Information Centre. Marine toxicology cases were retrospectively analyzed for a 20-y period (January 1, 1995 to December 31, 2014). Data were extracted from archived consultation forms. Descriptive statistics are presented, and post hoc analyses compared age, sex, province, and caller's background with severity and type of toxicology. A total of 311 calls involved 392 cases. Most calls involved adults (n=317, 81%) and males (n=214, 55%) and presented with no or minor symptoms (n=242, 62%). Poisoning from ingestion (n=239; 61%) was more commonly encountered than was marine envenomation (n=153; 39%), with paralytic shellfish poisoning (n=118; 30%), scombroid poisoning (n=93; 24%), and envenomation from stingrays (n=36; 9%) and bluebottles (n=33; 8%) occurring often. Healthcare professionals were more likely to consult for severe cases (odds ratio 3.3; 95% CI 1.9-5.9) and poisoning-related cases (odds ratio 1.8; 95% CI 1.1-2.9). The proportion of marine-related toxicology cases was low. Telephonic consultations by healthcare professionals relating to poisoning were generally of a serious nature. The data can be used to drive public health awareness campaigns.