Toxicology testing to detect suspected poisoning cases or cases where the cause of death is undetermined is not yet being done in the CHAMPS panel of tests. This leaves a gap in understanding the contribution of poisoning to under-5 mortality. Routine admission records from Chris Hani Baragwanath Hospital pediatric wards have previously shown high hospitalization rates from suspected poisoning. As a test case, the CHAMPS South Africa site conducted mass spectrometry analysis on a case of suspected poisoning and the substance naphthalene, which is found in mothballs, was detected. Mothballs are a household item that is sold in supermarkets and at street vendors in South Africa. The shape and color of mothballs resemble a hard candy and can easily be ingested by a small child. Unfortunately, we were unable to contact the mother of the child who demised to provide her with this information. However, we discussed these findings with the community advisory board as a way of raising awareness of the potential for child poisoning through mothballs or other poisonous substances. In addition, we are conducting further testing on samples where the cause of death was undermined to assess whether they may be a result of poisoning. Such findings are needed to fully address the issue of poisoning in children and to justify the need for inclusion of toxicology testing in future CHAMPS cases.

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Case study_CHAMPS_CHAMPIONS_Toxicology_SA_VFinal July2024