THE EPIDEMIOLOGY AND CLINICAL-FEATURES OF PARAFFIN (KEROSENE) POISONING IN RURAL AFRICAN CHILDREN

One hundred and eleven children under 5 years of age admitted with a d iagnosis of paraffin ingestion, constituting 9.1% of total ward admiss ions in this age group, were studied prospectively. The majority were between 13 and 36 months old. One-fifth of the children were in the ca re of another child at the time of ingestion. Fourteen families had a past history of paraffin ingestion. Only 22% of households normally st ored paraffin above ground level and in only 15% of cases was paraffin stored in a container specified for that purpose. Emesis was attempte d using home remedies in 72% of cases and was associated with a signif icant increase in vomiting. Vomiting had an impact on the exacerbation of the clinical features of paraffin poisoning, particularly fever. C linical criteria laid down for suspected superadded bacterial lung inf ection resulted in half of the study group having blood cultures perfo rmed on day 1 and another 17 on day 4. Only two yielded isolates which possibly could have been indicative of bacteraemia secondary to infec tive pneumonia. No child in the suspected group was treated with antib iotics and all recovered uneventfully. Admission chest X-rays contribu ted little to the management of the illness. Paraffin ingestion remain s a serious contributor to child morbidity in rural South Africa and t here appears to be room for further preventive education at community level. Specific measures could include storage of paraffin in designat ed containers above ground level and emphasis on adult supervision of children. Superadded bacterial pneumonia is uncommon and antibiotics i n the management of suspected cases are not routinely indicated.