A review of patients presenting to accident and emergency department with deliberate self-harm, KwaZulu-Natal, South Africa

Abstract

BackgroundThe World Health Organization has described deliberate self-harm (DSH) as a major global health challenge. Little is known about the profile of patients admitted following DSH at district and regional combo hospitals in KwaZulu-Natal, South Africa.AimThe aim of this study was to assess the profiles of patients and reasons for admission following DSH.SettingThe study was conducted on data from a busy Accident and Emergency (A&E) department in a combination district and regional hospital situated in Empangeni in northern KwaZulu-Natal.MethodThis was a retrospective descriptive study. Data were collected from charts of all patients admitted to the A&E department from April 2012 to March 2013 following DSH. Variables assessed included age, gender, race, occupation, religion, education level, coexisting medical and mental health conditions, and reasons for DSH. Data were entered into SPSS and analysed descriptively.ResultsA total of 262 charts were identified and 215 (82%) were selected for inclusion. Most patients admitted following DSH were young, single African women with at least secondary-level education. Most (169/215;78%) admissions were for parasuicide, with relational issues contributing in more than 50% of cases and circumstance challenges contributing in just under 30%.ConclusionAlthough an underestimation, DSH is not an uncommon reason for patients to present in the A&E at this district and regional combo hospital. Findings from this study are consistent with those of other studies on DSH and highlight the need for a validated screening tool for the identification of patients at risk of DSH. There is a need to explore community-based intervention, which could address reasons for DSH and prevent future admissions.

Profile of parasuicide cases attending Brits Hospital, North West Province, South Africa: a 5-year chart review

“…13 However, the contrary was noted in Pakistan where married women have been identi ed as vulnerable. 7 Unemployment (63.7%) was found to be associated with parasuicide in the current study as it was also noted in Egypt, 9 as well as in South Africa, more speci cally in Limpopo 11 and Durban 12 . Although more victims of parasuicide were at the secondary level of education, 62.8% in the current study, in Egypt more participants were currently at or had completed the secondary or tertiary level of education.…”

“…In South Africa, although the age groups are not delimited, quite a number of studies conducted on parasuicide have highlighted younger age groups as susceptible to suffer this phenomenon. [12][13][14][15] With respect to gender, females (62.3%) have been considered by the current study as more vulnerable than males. This difference has been noted in the European multicentre study 4 , the Pakistan study 7 , the Egyptian study 8 , in Durban 12 as well as in Cape Town 14 (both in South Africa), while in Edinburg (United Kingdom) 5 as well as in Australia 6 there were no signi cant differences between the sexes.…”

“…10 And continuing in South Africa, in Limpopo province as well as in Durban, depression and other conditions such as HIV were noted among the parasuicide cases. 11,12 The main reasons for parasuicide deduced from research at Brits Hospital were a relationship problem (43.4%) followed by unemployment (29.4%). Patients alluded to a relationship problem, or romantic relationship, in the Western Cape, South Africa 10 as well as in Pakistan where marital con icts were causing stress to women.…”

“…A screening strategy to diagnose depression may be considered in the comprehensive management of our patients, in order to prevent or reduce the parasuicide phenomenon. 12 A one-year retrospective and descriptive study using patients' records was conducted in northern KwaZulu-Natal, South Africa. Only patients who presented at the casualty department of the hospital and had deliberate self-harm (DSH) as diagnosis quali ed for this study because the target was to determine the pro le of the patients and the reasons for DSH.…”

Emergency management of calcium channel blocker overdose

“…[7,8] Medicine-related poisonings predominate and are often severe, requiring emergency care. [7][8][9][10] Medications typically reported are those that are easily accessible or are prescribed by healthcare professionals, with prescription drugs identified as being of particular concern in deliberate self-harm. [7] Many of these prescription drugs form part of the essential drugs list, such as CCBs.…”