Patterns of paediatric analgesic use in Africa: a systematic review

Madadi, Parvaz; Enato, Ehijie; Fulga, Shir; Umeoduagu, Chinonye C; MacLeod, Stuart; Koren, Gideon; Einarson, Thomas R.

doi:10.1136/archdischild-2012-302386

Cited by 15 publications

(11 citation statements)

References 40 publications

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“…For these reasons, the attending physicians may have avoided prescribing opioid analgesics for outpatients even though there is no regulation against the practice. This finding is in keeping with the results of a systematic review of paediatric analgesic use in Africa which reported that only 0.2% of children had opioid analgesic prescribed43. This is in contrast to current guidelines that recommend rapid initiation of opioids in the management of vaso-occlusive crises37.…”

Section: Discussionsupporting

confidence: 79%

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

et al. 2018

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BackgroundSickle cell disease (SCD) is a genetic haematological disorder that affects millions of people around the world especially people of African heritage. The treatment of the symptoms of SCD includes the use of analgesics, antibiotics, and anti-malarial drugs. Studying the pattern of drug prescription is a veritable tool for establishing the current practice and how it conforms to existing guidelines.ObjectivesThe main objective of this study was to assess the pattern of drug prescription in children with sickle cell disease (SCD) attending the paediatric outpatients' clinic of a tertiary care centre in Ado-Ekiti, South-West Nigeria.MethodsThis was a cross-sectional retrospective study carried out using the medical records of all patients with SCD who attended the paediatric outpatient clinic of the teaching hospital between January 1 and December 31, 2014. The information retrieved from the case notes included the bio-demographic data, associated co-morbid conditions and the list of prescribed drugs.ResultsA total of 202 SCD patients aged below 18 years were seen in the clinic during the study period with males accounting for 61.9% of them. The mean age of all patients was 6.9 ±3.8 yrs. A total of 1015 medications were prescribed during the study period giving a mean of 5.02 ± 1.9. Vitamins/micronutrients, anti-malarial drugs, antibiotics and analgesics accounted for 41.4%, 29.0%, 15.7% and 13.9% of all prescribed drugs respectively. Antibiotics from the penicillin group were the most commonly prescribed followed by macrolides and cephalosporins while Ibuprofen (60.3%) and Acetaminophen (32.6%) were the commonly prescribed analgesics.ConclusionHigh rate of antibiotic prescription, low use of opioid analgesics and non-prescription of prophylactic penicillin/pneumococcal vaccination were the main findings in this study. There is need for the introduction of standard treatment protocols for this group of patients.

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Section: Discussionsupporting

confidence: 79%

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

et al. 2018

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“…With respect to narcotic analgesics, many governments in LMICs are adopting overly restrictive national drug control policies due to their high resale value and concern about addiction . This is particularly tragic, resulting in pain being the most undertreated symptom in patients in the developing world; and for a child or adult with cancer and low prospects for cure, appropriate palliation is often unavailable .…”

Section: Barriers To Equitable Drug Access For Children In Lmicsmentioning

confidence: 99%

Regulatory and logistical issues influencing access to antineoplastic and supportive care medications for children with cancer in developing countries

Wiernikowski

MacLeod

2014

Pediatric Blood & Cancer

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Globally there are numerous impediments, both logistical, regulatory and more recently global drug shortages, hindering pediatric access to therapeutic drugs of all types. Efforts to reduce barriers are ongoing and are especially important in low and middle income countries and for children requiring treatment of conditions such as those encountered in pediatric oncology characterized by the risk of life threatening treatment failures. Progress has been made through the efforts of the World Health Organization and regulators in the US and Europe to encourage the development of therapeutic agents for use in pediatrics and measures taken have fostered the availability of stronger pediatric data to guide therapeutic decisions. Nonetheless, pharmaceuticals remain a global commodity, subject to regulation by the World Trade Organization and this has often had detrimental effects in low and middle income countries. This article emphasizes the need for closer international collaboration to address the barriers currently impeding access to antineoplastic and supportive care medicines for children.

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“…There are, in addition, some very practical issues in pediatric therapeutics that are likely to gain deserved attention from the next generation of pediatric pharmacologists, including, for example, burn treatment, palliative care, management of childhood cancer, and development of new approaches to severe pain in chronic conditions such as cancer, sickle cell anemia, or major physical deformities [82,83]. A comprehensive research strategy is urgently required.…”

Section: Conclusion and Actionsmentioning

confidence: 99%

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

et al. 2013

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A commentary is presented on the urgent need for a comprehensive effort to improve the practice of pediatric therapeutics in Africa. A call for action is addressed to a variety of practitioners internationally, many of whom possess skills that could be fruitfully applied to the improvement of health outcomes for African children. Successful engagement with the many challenges requires the complementary effort of researchers in basic and clinical pharmacology and toxicology, nurses, pharmacists, physicians, clinical pharmacologists, clinical pharmacists, and political leaders and civil servants. While a comprehensive or systematic review of the relevant literature has not been attempted, the authors have highlighted promising initiatives driven by international agencies and academic networks. Two African perspectives are presented to reinforce the prospect of child health gains that can be achieved through consistent pursuit of optimal therapy for conditions such as respiratory infection, diarrhea, malaria, and HIV/AIDS. There is an imperative for development of north-south and south-south partnerships that will amplify current research efforts and mobilize existing knowledge concerning pediatric drugs. The overall goal is a multidisciplinary commitment to making essential medicines available at the right time, the right place, and in the right formulation for African children from infancy to adolescence.

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Patterns of paediatric analgesic use in Africa: a systematic review

Cited by 15 publications

References 40 publications

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

Prescription audit in a paediatric sickle cell clinic in South-West Nigeria: A cross-sectional retrospective study

Regulatory and logistical issues influencing access to antineoplastic and supportive care medications for children with cancer in developing countries

Better Drug Therapy for the Children of Africa: Current Impediments to Success and Potential Strategies for Improvement

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