Medication among Children in Africa South of Sahara: Qualitative Systematic Review  

Professor Ebba Holme Hansen and Professor Susan R. Whyteehh@farma.ku.dk

University of Copenhagen, Denmark

Copenhagen University’s Global Health Cluster temporary fund provided partial funding 

Problem statement•The use of medicines is an important aspect of child health•Children are not just “small adults”•However, this topic has been sparsely dealt with in international research, not least in low-income societies.

Objective•To provide an overview of empirical evidence on children and medication in Africa south of Sahara

Systematic searches conducted without restrictions in•Medline•Embase•Psychinfo

Structured by using the same search terms in similar combinations in all databases

In all searches:

• “children”• “Africa, south of Sahara”• “Children” defined as 0-18 years• “Medicines” defined by 80 different search

terms

Flow chart of included/excluded studies

Duplicates 719

- Purely economic studies- Diagnostic tools- Drug abuse- Purely clinical studies- Studies where children

and adults are mixed

830 potentially relevant articles

1530 potentially relevant

references

132 included studies

Data handling and extraction

Titles and abstracts assessed for eligibility

Full text papers

Extraction on data sheets

Malaria

Diarrhoea

Fever

ARI

Epilepsy

Cough

Pneumonia

Asthma

Worms

Trachoma

Childhood illnesses general

Illnesses – in 132 studies

Main points

•132 studies from 24 countries

•Most studies dealt with children under 5 years

In many studies age group was not specified

•Very few studies on prescribing and use

•Most studies recognised the multiple sources of treatment (popular, professional, folk sectors)

Main points (contd.)

•Doses, dispensing, dosage forms barely mentioned

•Few studies on perceptions

•No reviews of the field of children and medicines in Africa

Implications

• This study shows that medicine use in children is a neglected topic– except medication treatment of malaria/fever and diarrhoea in

small children

• As medicine use behaviours may track from childhood and adolescence into adulthood, knowledge about this topic also have implications for the improvement of medicine use in future adult populations

• The study indicates a lack of research interest in, particularly, older children as autonomous beings

• This little research only provides hints about proper interventions and policies to improve use of medicines among children

• Research to lay the foundation for future interventions should be high on the agenda

Research gaps

• Studies on medicine use for chronic conditions and acute conditions other than malaria/fever and diarrhoea

• Characterisation of issues specific to children over 5

• The meaning and implications of (lack of) dosage forms for children

• Analyses of policies of relevance to children’s medicine use

• Children’s own experiences and the meaning of medicines in their daily lives.