Gambia bans paracetamol syrup after child deaths

The authorities in Gambia have suspended all sale and importation of paracetamol syrup products amid concern they may be linked to "dozens" of fatalities among children in the last three months.

An investigation is focusing on deaths mong children under the age of five who developed acute kidney injury after being given paracetamol syrups to treat fevers, raising fears that substandard or falsified products may be responsible.

There's no indication from the authorities yet about the possible causes of the liver toxicity. Paracetamol itself – also known as acetaminophen – is known to cause damage to kidney tubules if overdosed.

Meanwhile, kidney injury has in the past been linked to glycerin – an excipient used in many syrup-formulated medicines – which has been contaminated with diethylene glycol (DEG), a compound known to be highly damaging to the kidneys.

In the last few decades, there have been hundreds of fatalities associated with DEG contamination in countries including Nigeria, Panama, India and Bangladesh.

Gambia's Medicines Control Agency (MCA) isn’t jumping to conclusions about the cause of the outbreak. However, it has revealed that it has sent samples of various paracetamol products overseas for quality testing.

The World Health Organisation (WHO) meanwhile has said that the deaths may be due to an infectious disease – possibly spread through contaminated water – although it stressed it was too early to make an assessment.

According to WHO statistics, 42 per cent of detected cases of substandard or falsified pharmaceuticals occurred in Africa, and the agency has called for strengthened capacity at national medicine regulatory authorities (NMRAs) to help ensure that only safe, good quality and effective medical products are available in the supply chain.