Notification of Pesticide Poisoning: Knowledge, Attitudes and Practices of Doctors in the Rural Western Cape

Abstract

Objective: To cvaluaic the impact of a surveillance intervention on tile knowledge attitudes and practices of rural doctors in the Western Cape. Study Design: Intervention study. Comparison of subjects in an index area in the Western Cape with those of a control before and after an intervention aimed at improving notiication of pesticide poisoning. Subjects: Doctors in private and public pactice who provide primary or secondary care services to victims of pesticide poisoning. Main Outcome Measures: Knowledge, altitudes and reported practices relating to the diagnosis, management and notification of pesticide poisoning. Results: An increase in awareness of pesticide poisoning as a notifiable condition was achieved in the intervention area, particularly for non-hospital doctors, as was an increase in the number of reported pesticide poisonings diagnosed in the preceding year in both intervention and control areas. Doctors in the intervention area also appeared to improve their perceptions as to the main causes of pesticide poisoning. However, none of the other measures of knowledge, attitude or practice were improved, including the percentage of poisonings thai were notiied. Obstacles to notification included excessive paperwork, poor contact with health authority staff and previous experience of lack of feedback in notified cases. The intervention appeared tb address the last problem bill oiled to address the otiier main reasons. Conclusion: Limited objectives of increasing awareness of pesticide poisoning as a notiiable condition (and of increasing practitioner's diagnostic index of suspicion for pesticide poisoning) may be achievable With a relatively low input surveillance intervention. However, other strategies may be more fruitful in improving notification in rual areas. Attention needs to be paiil to improving the orientation of rural practitioners to the prevention of pesticide poisoning.