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Deaths from suspected mothball poisoning in children
M Dempster1, L Erasmus1, S Johnstone1
1South African Medical Research Council Vaccines and Infectious Diseases Analytics Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
Summary
Childhood mothball poisoning caused three South African children
Area of Science:
- Toxicology
- Pediatric Health
- Forensic Science
Background:
- Childhood poisoning is a major health issue in South Africa, particularly in informal settlements.
- Poisoning contributes significantly to pediatric hospital admissions, with common causes including fuels, pesticides, and medicines.
Purpose of the Study:
- To investigate the cause of death in three children presenting with similar symptoms.
- To highlight the need for advanced toxicology screening in pediatric poisoning cases.
Main Methods:
- Analysis of postmortem fine-needle liver biopsies using atmospheric pressure matrix-assisted laser desorption/ionisation mass spectrometry imaging (AP-MALDI-MSI).
Main Results:
- AP-MALDI-MSI identified naphthalene-associated metabolites in the liver biopsies.
- Naphthalene is the active component in household mothballs, indicating accidental ingestion as the cause of death.
Conclusions:
- Accidental ingestion of mothballs led to the deaths of three children.
- There is an urgent need for improved toxicology screening tools and robust toxicovigilance strategies to prevent childhood poisoning.
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