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Arch Dis Child 97:1086-1091 doi:10.1136/archdischild-2012-302386
  • Drug therapy

Patterns of paediatric analgesic use in Africa: a systematic review

  1. Thomas R Einarson2,6
  1. 1Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
  2. 2Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3Department of Clinical Pharmacy and Pharmacy Practice, University of Benin, Benin City, Nigeria
  4. 4Child and Family Research Institute, University of British Columbia, Vancouver, British Columbia, Canada
  5. 5Provincial Health Services Authority, Vancouver, British Columbia, Canada
  6. 6Department of Pharmacy, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Parvaz Madadi, Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada M5G 1X8; parvaz.madadi{at}sickkids.ca, parvaz.madadi{at}gmail.com
  • Received 22 May 2012
  • Accepted 10 August 2012
  • Published Online First 13 September 2012

Abstract

We conducted a systematic literature review with two objectives: (1) to assess reported patterns of analgesic use in African children and compare these observed patterns to the analgesics given in the WHO Essential Medicines List for Children (EMLc); and (2) to summarise outcomes related to effectiveness, adverse events, cost and accessibility of these analgesics. Eligible participants were children (≤12 years) living in any African country who received an analgesic administered with the intention of relieving pain in any setting. Thirty-four peer-reviewed, observational studies representing 7772 African children were accepted. Studies were conducted in 25 different regions of 12 countries. Pain was attributed to surgery, burns, sickle cell anaemia and conditions requiring palliation in 32% of children, and was unspecified in the other 68%. Of the three EMLc analgesics, paracetamol and ibuprofen were widely employed, constituting ∼60% of all analgesics, while morphine was used in 20 children (0.2%). There were 455 suspected adverse drug reactions which included 17 deaths. Analgesic use reported in African children appears to fall short of WHO standards.