About 30 children have died in various hospitals around the country after a teething drug was administered to them

The merchants of death in the Nigerian pharmaceutical sector are at work again. Last week, more than 30 children between the ages of four months and two years were reported to have died after using contaminated teething mixture identified as My Pikin.

Dora Akunyili, director-general, National Agency for Food, Drugs Administration and Control, NAFDAC, who confirmed the report, said 15 children died at the Lagos University Teaching Hospital, LUTH, eight died at the Ahmadu Bello University Teaching Hospital, ABUTH, Zaria, while two deaths were recorded at the University College Hospital, UCH, Ibadan. 

Akunyili explained that many of the toddlers who took the contaminated drug are still on admission in the hospitals and it has been established that they developed renal failure caused through the administration of My Pikin. The children who have been using the drug had the symptoms of fever, diarrhoea, vomiting and inability to urinate.

She lamented that in spite of the fact that LUTH and UCH experienced these symptoms and cases of kidney failure associated with the drug, NAFDAC was not informed until November 19, when a pharmacist at ABUTH informed her. “It is unfortunate that the first incident occurred over three weeks ago in LUTH but NAFDAC just found out about it November 24, when we visited LUTH during the course of our investigation. This is a public emergency that requires the collective action and co-operation of all health care providers, the media and general public in averting the looming danger facing millions of our innocent children,” she said.

To avoid further deaths from the use of the drugs, NAFDAC has begun clearing up all batches of the drug in circulation.

But Akin Osibogun, chief medical director of LUTH, said the hospital did not hold back information on the drug, insisting that it was reported to the federal ministry of health which has an epimiology department. He, however, said that “it was still premature to say conclusively that the deaths were caused by the teething mixture.”

James Renner, chairman, medical advisory committee, LUTH, said there was need for a check to be carried out on other drugs. According to him, while LUTH does not want to join issues with NAFDAC, there are some questions begging for answers. “For instance, we understand the agency did the quality control check of the product some four months ago. Meanwhile, serial batches need to have quality control conducted by the agency. The quality assurance unit of NAFDAC has some more jobs to do,” he said.

He revealed that LUTH was testing for clues that could lead to the confirmation of its observation. “We are carrying out investigations on antibiotics, teething powder, milk and ‘My Pikin,’ all administered to children. We did not want to create panic by saying this or that is the drug that was responsible, hence, we stick to evidence-based medicine. And when we come out with our reports, we will submit to the right authorities, for we all report to the federal ministry of health,” Renner said.

Adeniyi Adenipekun, chairman, medical advisory committee, UCH, also refuted the allegation. According to him, “nobody died in this hospital as a result of the use of any teething mixture.” 

Worried by the number of children who have died after allegedly taking the drug, Mohammed Lawal, acting minister of health, has ordered an investigation into the matter. He directed the officials of NAFDAC and some experts from the federal ministry of health to unravel the cause of the deaths and report back to him. The ministry of health is also collaborating with the World Health Organisation, WHO, on the issue.

My Pikin is a teething mixture manufactured by Barewa Pharmaceuticals Limited in Akowonjo, Lagos. But as a result of the alleged deaths, NAFDAC has ordered that the company be shut down because laboratory analysis of the drug has revealed that a chemical known as diethylene glycol was the cause of the deaths. Diethylene glycol is an organic solvent chemically related to ethylene. Upon metabolic conversion, it becomes oxalic which is toxic and can damage the kidney. However, as the controversy over the killer-syrup rages, the management of Barewa Pharmaceuticals Limited, manufacturer of  My Pikin, refuted the claim by NAFDAC  that its product cause the death of children, Kola Okunlola chairman of the company, said they were surprised by NAFDAC’s claim the company said that since it wa licenced by NAFDAC to produce the drug, it has produced thousand of its units for more than two years without any complaints from user or the regulatory agency. The group stated: “As responsible corporate citizen of Nigeria and one that is involved in the protection and promotion of good health, we are shocked at the claim of deaths of children in some of the nation’s hospitals.

“We are, however, bothered that there are conflicting claims between NAFDAC and the teaching hospitals regarding the deaths and the causes of the deaths.”

Some doctors who spoke to Newswatch last week said they did not know the drug. For instance, George Akpede, chief medical director, Irrua Specialist Teaching Hospital in Edo State, told Newswatch that the name of the drug is strange to him and that it is unfortunate that the country is experiencing this again after the incident of the 1990s when a certain paracetamol brand killed many children in Nigeria.

He urged mothers to understand that teething problem in children is a natural phenomenon and harmless. He said it was wrong for them to administer teething powder or syrup for the purpose of treating a baby because of teething problem. “Teething problem in children is transient and harmless. It is not a disease, so if at all any drug should be considered, it is the simplest of pain reliever such as paracetamol or ibuprofen,”  he said.

Similarly, Osamudiamen Omoro-gieva, a gyneacologist and medical director, Ola-Iya Specialist Hospital, Ojuelegba, Lagos, said he is not aware of the drug. “I have never heard about such a drug before and I do not believe in any teething drugs, because teething is normal in children and it is not something you have to use drug for. But with this experience, I think mothers must have learnt their lesson,” he said. He said in order to avoid a reoccurrence of the ugly incident, mothers need education on how to handle their children when they are having teething problem.

Ben Umeh, a gyneacologist with Bolanle Hospital, Allen Avenue, Ikeja, said the drug is usually administered by some doctors as teething powder. He, however, stated that the harm caused by the drug could be because it is of low quality. Besides, during production, some chemicals that affect the wind pipe must have been added thereby, affecting the breathing system of the child.

He explained that during teething, children usually pick something from the ground and put in their mouth due to the irritating gum and in the process, they pick virus which could make the child to develop diarrhoea. He condemned self medication and advised mothers to consult doctors on all health matters.

Jide Idris, commissioner for health, Lagos State, said apart from the suspected teething mixture, other possible causes of the deaths could be herbal concoctions, overdose of paracetamol, and poisoning. He urged health facilities treating cases of children with inability to pass urine or puffiness of the face to report such cases to LUTH, LASUTH or the ministry of health for proper medical attention.

He also directed that all cases of acute renal failure either in public or private hospitals be immediately reported to the disease control directorate of the ministry so as to enable the state government to curb the spread of the disease and remedial actions be mounted for its control.