Pre-Hospital use of Paracetamol in the Rivers State University Teaching Hospital Paediatric Outpatient Clinic

Woroma Wonodi *

Department of Paediatrics, Rivers State University Teaching Hospital, Nigeria and Department of Paediatrics and Child Health, Faculty of Clinical Sciences, College of Medical Sciences, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Nigeria.

Boma Awoala West

Department of Paediatrics, Rivers State University Teaching Hospital, Nigeria and Department of Paediatrics and Child Health, Faculty of Clinical Sciences, College of Medical Sciences, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Nigeria.

*Author to whom correspondence should be addressed.


Abstract

Background: Paracetamol is a medication that is often procured over the counter in many nations including Nigeria. It is therefore prone to abuse/misuse with consequences.

Objective of the Study: To determine the prevalence of pre-hospital use of paracetamol, preferred formulation, appropriateness of dosing and factors associated with its use.

Methodology: An observational study involving 401 caregiver/child pair seen at the Paediatric clinic of the RSUTH over 6 months. Data on demography, clinical symptoms, weight of the children as well as pre-hospital paracetamol use were obtained using a semi-structrured questionnaire. Informed consent was obtained from the caregivers.

Results: A total of 401 caregivers/child pairs participated in the research with male predominance. The average age of the children was 28.26 ± 3.80months. Most of the parents were aged 30-40 years, traders/businessmen with tertiary level of education.

About 40% of children received paracetamol before presentation at the hospital with fever being the most common reason. Syrup was the preferred formulation while 0.6% received injection paracetamol. The most common reason for formulation type was the age of the child followed by available paracetamol formulation at home. Most parents gave paracetamol twice daily, for less than seven days and based on past experiences.

The most common diagnosis among parents that gave paracetamol was malaria. A quarter of children received underdose and 5.4% overdose medication.

Conclusion: Pre-hospital paracetamol self-medication is common with syrup paracetamol being

the most common formulation used. There was a high abuse of paracetamol thus education of the populace on appropriate pre-hospital paracetamol use would help reduce this menace.

Keywords: Abuse, paracetamol, pre-hospital, self-medication, pharmaceutical drug, anti-inflammatory


How to Cite

Wonodi, Woroma, and Boma Awoala West. 2024. “Pre-Hospital Use of Paracetamol in the Rivers State University Teaching Hospital Paediatric Outpatient Clinic”. Asian Journal of Pediatric Research 14 (6):27-36. https://doi.org/10.9734/ajpr/2024/v14i6352.

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References

Health Direct. Paracetamol. www.healthdirect.gov.au/paracetamol

Sharma CV, Mehta V. Paracetamol: Mechanisms and updates. Continuing education in Anaesthesia. Critical care & pain 2014;153-8. DOI: 10.1093/bjaceaccp/mkt049

Obu HA, Chinawa JM, Ubesie AC, Eke CB, Ndu IK. Paracetamol use (and/or misuse) in children in Enugu, south-east Nigeria. BMC Pediatrics 2012;12:103 Available:https://www.biomedcentral.com/1471-2431/12/103

Ajayi O, Falade CO. Pre-hospital treatment of febrile illness in children attending the General outpatient clinic, University College Hospital, Ibadan, Nigeria. Afr J Med Med Sci. 2006;35(1):85-91

Daifallah A, Jabr R, Al-Tawil F, Elkourdi M, Salman Z, Koni A, Samara A, Al-Jabi SW, Zyoud SH. An assessment of parents’ knowledge and awareness regarding paracetamol use in children: A cross-sectional study from Palestine. BMC Public Health. 2021;21:380-90

Barry HR. Chemical and drug poisoning. In Nelson textbook of Pediatrics. 21st edition. Edited by Nelson WE, Behrman RE, Kliegman RM, Arvin AM. Philadelphia: WB Saunders Company;

Fadare JO, Olatunya OS, Babatola AO, Omoniyi E, Taiwo AB. Pre-hospital treatment of children with fever: beliefs and practices of caregivers in Ado-Ekiti, south-west Nigeria. Rwanda Med J. 2021;78(1): 30-7.

Mason S, Thorp S, Burke O. Pre-hospital use of paracetamol among children attending the accident and emergency department. Emerg Med J. 2003;20(1):88 DOI: 10.1136/emj.20.1.2-a

Gehri M, Guignard E, Djahnine SR, Cotting JQ, Yersin C, Paolo ERD, Krahenbuhi JD, Pannatier A. When fever, paracetamol? Theory and practice in a Paediatric outpatient clinic. Pharm World Sci. 2005; 27(3):254-7 DOI: 10.1007/s11096-004-4771-x

Upfal J. The Australian drug guide, 7th ed. Melbourne Black Inc; 2006.

Suzan SM. Toxicology. In Pediatrics: Just the facts. 1st edition. Edited by Thomas G, Wayne F, Robert RT. Boston: McGraw-Hill. 2005;71.

Utpal KS, Ramesh KP. Acetaminophen poisoning. In Principles of Pediatric and neonatal emergencies. 2nd edition. Edited by Sachdev HPS, Panna C, Arvind B, Krishan C, Siddarth R, Ramesh KP. New Delhi: Jaypee Brothers. 2004;436.

Park A. The FDA’s painkiller warning: how to avoid taking too much. Time. Available:http://www.time.com/time/health/article/0,8599,1572012,00.html. December 20, 2006.

Accessed On: 27, 2024.

FDA may restrict acetaminophen. Webmd.com.2009-07-01. Available:http://www.webmd.com/pain-management/news/20090701/fda-may-restrict-acetaminophen

Bilenko N, Tessler H, Okbe R, Press J, Gorodischer R. Determinants of antipyretic misuse in children up to 5 years of age: a cross-sectional study. Clin Ther 2006; 28(5): 783-93

DOI: 10.1016/j.clinthera.2006.05.010

Kapasi AA, Lorin MI, Nirken MH, Yudovich M. Parents’ knowledge and sources of knowledge about antipyretic drugs. J Pediatr 1980;97(6):1035-7

Chang MC, Chen YC, Chang SC, Smith GD. Knowledge of using acetaminophen syrup and comprehension of written medication instruction among caregivers with febrile children. J Clin Nurs. 2012; 21(1-2):42-51

Barrett TW, Norton VC. Parental knowledge of different acetaminophen concentrations for infants and children. Acad Emerg Med. 2000;7(6):18-21

Walsh A, Edwards H, Fraser J. Influences on parents’ fever management: Beliefs, experiences and information sources. J Clin Nurs 2007;16(12):2331-40

Oyedeji GA. Socioeconomic and cultural background of hospitalized children in Ilesa. Niger J Paediatr 1985; 12: 111-7

Alonso-Castro AJ, Ruiz-Noa Y, Martínez-de la Cruz GC, Ramírez-Morales MA, Deveze-Álvarez MA, Escutia-Gutiérrez R, Carranza-Álvarez C, Domínguez F, Maldonado-Miranda JJ, Ruiz-Padilla AJ. Factors and Practices Associated with Self-Medicating Children among Mexican Parents. Pharmaceuticals (Basel). 2022;15(9):1078. DOI: 10.3390/ph15091078 PMID: 36145300; PMCID: PMC9502490.

Nithisha T, Sharma SK. Extent and pattern of paracetamol usage for children and knowledge and attitude towards its usage among parents attending an outpatient clinic in Warangal district of Telangana. International Journal Of Community Medicine and Public Health. 2018;5(6): 2394–2399.

Eberechukwu, YIL, Aderonke, SO. Perception and management of fever in children, by mothers in port harcourt Nigeria. International Journal of Tropical Disease & Health. 2019;36(4):1–8 Available:https://doi.org/10.9734/ijtdh/2019/v36i430150

Li SF, Lacher B, Crain EF. Acetaminophen and ibuprofen dosing by parents. Pediatric Emergency Care. 2000;16 (6):394-397.

Goldman, RD, Scolnik D. Underdosing of acetaminophen by parents and emergency department utilization. Ped Emerg Care. 2004;20(2):89-93.