Challenges in pediatric science

BY ZEMENE YOHANNES                                                The Ethiopian Herald March,1,2013

“It’s a 'riddle' that has frustrated pediatricians for decades,” wrote one of the science journalists while investigating the least known and the hidden reality about child medicine. When children are ill and need curing drugs, it would not be easy for physicians to order drugs  as few medicines are approved globally for use. Handfuls of recent studies including a report by the US government health institute are convinced the fact that most doctors are forced to prescribe drugs for  children without adequate data, risking the children for overdose with a high possibility to leave its long term  side effects.

“The adage that a child is not just a small adult is true: you can’t simply scale-down a dose of a drug from adults and expect it to behave identically in a small child,” says Peter Adamson, a pediatrician and pharmacologist at Children’s Hospital of Philadelphia. A study conducted  in USA  also revealed the seizure drug Gabapentin (commonly known as neurontin) requires higher than expected doses for children younger than five. To the contrary,  this medicine can make them aggressive and hyperactive. Pain relievers, antibiotics and asthma medications, among other drugs, are often prescribed off label, the practice of prescribing pharmaceuticals for an unapproved indication. One can imagine the outcome of such side effects that might be uncurable even by pediatricians themselves.

Drug prescribing practice in the pediatrics ward is one of the many problems that still need serious attention. According to a  study published in International Research Journal of Pharmacy and Pharmacology pertaining to the case of Ethiopia with a reference to Jimma University, School of health pediatrics ward , Vol. 2(6) pp. 132-138, June 2012, by  Agalu and Mekonnen, the problem in discussion is a growing concern in the nation.   

According to the study,  the data have shown as many drugs were prescribed without full information about the usage and dosage of the medicines, most of the drugs prescribed were not also from the essential drug list of Ethiopia, some drugs had been found given without indicating the dose, improper doses were found given too. This would be a good example on  how the practice of pediatrics in our country is facing multiflorous challenges.

The writer's of this piece recent observations over scientific journals and local hospitals proved him the level of the problem with respect to the skills of our pediatricians. A mother whose child was ill -whom he found her at one clinic- could not get the right cure at one higher clinic in Addis Ababa, and she was made to see another clinic, for instance. Most amazingly, the dose of the drug she was given had been said improper by the second doctor she saw.   This lead everyone to ask how kids are treated in the third world particularly, in Ethiopia. Basically in our country  medical science is at its young age, but our doctors application is almost similar for adult and children.   Not only that,  they also prescribe the disapproved ones.

 It is evident that our country has  the least  number of hospitals and doctors in Africa.  Information pertaining to the number of pediatricians we have is also hard to come by. Since most Ethiopians have no clear understanding as to the difference exists among pediatrician and medical doctor, we could not even make the right choice of clinics to take our kids  while they are sick. It is undisputed that getting treatment by  pediatrician  would bring the desired result in children's health than simply doing it by medical doctor.

Finding the right specialist in medication is another headache which needs more attention. As mistreatment is a major problem in our country, many people suffer from additional diagnosis mistakes made by doctors. The same happens to kids. It is commonly known fact as most people in our country take kids to doctors. Conversely, pediatricians rarely available at private clinics might cost lots of money for a simple check-ups than those at government health institutions.

Woizero Hilina Tasew, mother of three,  remembered what happened to her younger son who had been given a wrong medication with tablets that was disapproved by a second doctor, same case we treated earlier. “The first doctor told me my kid had got stomach bacteria and ordered him a bunch of medicines but he showed no improvement then I took him again to another well known pediatrician who disapproved the former doctor’s diagnosis and ordered me to stop giving the tablets. And he gave me medicines that can stop the symptoms of sickness, vomit and diarrhea. In fact it did help him.” She recalled.

Doctors are expected to read and update themselves with the ongoing scientific research findings  that are published every time around the world. In the developed world, doctors are expected to take a rigorous on job and professional trainings to maintain their skills and be competent with the modern medical science as well as  adopt new methods. In Ethiopia ,however, there is no clear ground that create impetus to people in the areas of health  to update themselves-the writer strongly believes.

Scientists now a days are advising to use home remedies to treat kids than rushing to hospital unless the sickness needs a serious medical attention. In fact, until these days no one exactly know where the problem with pediatrics lie, but doctors should be aware of the defect prevailing with the pediatrics. Moreover, children are not small adults who can resist the life time side effects of medicine. Stake holders in the health sector should, therefore, focus on improving the service with immediate remedies. Drug makers are now pushing to find a better way for child medication. But until the solution flourishes, no kid should die or suffer from lifetime side effects of drugs.