Enhanced surveillance for pesticide poisoning in the Western Cape--an elusive target

The poor state of reporting of pesticide poisoning is widely recognised as a hindrance to the development of preventive programmes that aim to address this important cause of mortality and morbidity in farm workers. This study aimed to assess the extent to which notification could be improved by enhancing passive surveillance procedures.

An awareness campaign targeting a range of health care providers was conducted in a rural farming area. This included improving the availability of cholinesterase testing and encouraging all providers to notify on suspicion. Existing reporting forms were supplemented with additional questions, and notification took place through existing channels. The rate of notification in the study area was compared with that in surrounding areas and previous years.

Fourteen poisoning events involving 56 people were reported, with 2 events together accounting for 44 cases. All patients were hospitalised. Over 90% of cases occurred on farms, with the farm store being the most common source of pesticide. Only one case was notified by a general practitioner. The rate of notification in the study area was approximately tenfold that of previous years and of the surrounding area for the same year (P < 0.0001).

Although the enhanced surveillance programme resulted in an increase in notifications, the programme appears to have been ineffective in detecting mild cases of poisoning or in improving notification on suspicion by general practitioners.