Incidence and cost estimate of treating pediatric adverse drug reactions in Lagos, Nigeria

Abstract

CONTEXT AND OBJECTIVES: Adverse drug reactions (ADRs) may cause prolonged hospital admissions with high treatment costs. The burden of ADRs in children has never been evaluated in Nigeria. The incidence of pediatric ADRs and the estimated cost of treatment over an 18-month period were determined in this study. DESIGN AND SETTING:Prospective observational study on children admitted to the pediatric wards of the Lagos State University Teaching Hospital (LASUTH) in Nigeria, between July 2006 and December 2007. METHODS:Each patient was assessed for ADRs throughout admission. Medical and non-medical costs to the hospital and patient were estimated for each ADR by reviewing the medical and pharmacy bills, medical charts and diagnostic request forms and by interviewing the parents. Cost estimates were performed in 2007 naira (Nigeria currency) from the perspectives of the hospital (government), service users (patients) and society (bearers of the total costs attributable to treating ADRs). The total estimated cost was expressed in 2007 United States dollars (USD). RESULTS:Two thousand and four children were admitted during the study; 12 (0.6%) were admitted because of ADRs and 23 (1.2%) developed ADR(s) during admission. Forty ADRs were suspected in these 35 patients and involved 53 medicines. Antibiotics (50%) were the most suspected medicines. Approximately 1.83 million naira (USD 15,466.60) was expended to manage all the patients admitted due to ADRs. CONCLUSIONS:Treating pediatric ADRs was very expensive. Pediatric drug use policies in Nigeria need to be reviewed so as to discourage selfmedication, polypharmacy prescription and sales of prescription medicines without prescription. CONCLUSÕES: O tratamento das RAD pediátricas foi bastante caro. As políticas de uso de drogas em pediatria na Nigéria devem ser revistas para desencorajar a auto-medicação, a prescrição de polifarmácia e a venda de medicamentos de prescrição sem prescrição.

Serious adverse drug reactions at two children’s hospitals in South Africa

“…Our proportion of serious ADRs considered preventable, i.e. 23%, is considerably lower than the findings in our adult serious ADR surveys, where 43 to 45% of ADRs were considered preventable [10,29], but is in keeping with proportions from Nigeria (20%) [21] and Ethiopia (33%) [22]. The most common reason why serious ADRs were considered preventable in this survey was an inappropriate choice of drug (15%), which was also the most common reason in our adult surveys [10,29] and one of the most common reasons (23%) cited in the 2012 systematic review [4].…”

“…However, our survey excluded admissions to the oncology ward, whereas the 2012 systematic review's figure is significantly influenced by two large surveys which found ADR-related admissions to oncology wards to be common [17,18]. Published subsequent to the 2012 systematic review [4], surveys from paediatric settings in sub-Saharan Africa suggested the proportion of admissions due to ADRs to be 5.7% (16/282) in Cape Town, South Africa [19], 4.7% (114/2433) in Eritrea [20], and 0.60% (12/2004) in Lagos, Nigeria [21]. A study from Jimma, Ethiopia, with paediatric adverse drug events as outcome (i.e., a slightly different outcome than ADRs), determined the proportion of admissions to be adverse drug event-related as 0.63% (4/634) [22].…”

Adverse drug reactions in hospitalized colombian children

“…Antibiotic use was related to a higher risk of ADRs emergence, as reported by Oshikoyay et al . 28 , and Martinez-Mir et al . 21 , who found that antibiotics were the most common cause of ADRs.…”

Descriptive study of adverse drug reactions in a tertiary care pediatric hospital in México from 2014 to 2017

“…In children, ADRs surveillance and documentation is crucial to monitor the safe use of the medications used in this population since, compared to adults, children may have higher vulnerability for experiencing ADRs because: a) clinical trials carried out in these population are scarce [2,3]; b) unlicensed and off-label drugs are often prescribed [4]; c) there is the possibility of exposure to medications during prenatal stage and breastfeeding [5], d) children may react differently than adults to administered medications, which can be explained by changes in absorption, distribution, metabolism and excretion [6], and e) hospitalized pediatric patients can be administered more than 10 drugs during their stay [7,8]. In the pediatrics setting, ADRs generate a significant impact on morbidity, mortality [9][10][11] and costs [12,13]. Frequency in hospitalized children ranges from 1.5% to 18.1%, while in outpatients it ranges from 0.7% to 2.74%; in addition 0.2% to 5.8% result in hospitalization [14,15].…”