The use and misuse of non-steroidal anti-inflammatory drugs (Ibuprofen) and paracetamol among mothers who presented with their children in health facilities in Enugu, South‒East Nigeria.

BACKGROUND: The availability of NSAIDs (ibuprofen) and paracetamol as over-the-counter drugs and the widespread use of these drugs in the management of fever in children have led to several forms of misuse. OBJECTIVES: This study aimed to document the pattern of misuse of NSAIDs and paracetamol among mothers who presented with their children in the outpatient clinics of 20 hospitals in the Enugu metropolis. METHODS: This cross-sectional study was conducted in twenty health centres among mothers who brought their children for follow-up, immunization, or other minor pediatric illnesses. One thousand mothers who attended both rural and urban health centers in Enugu metropolis were consecutively enrolled in the study. A validated interviewer-administered questionnaire was used for the study. RESULTS: The majority of the respondents (86.3%) gave either ibuprofen or paracetamol three to four times daily. NSAIDs (ibuprofen) were purchased mainly from patent medicine vendors (44.5%) and government hospitals (31.3%). The majority of the mothers (884, 88.4%) gave their febrile children ibuprofen, while 65 (6.5%) gave both ibuprofen and paracetamol, and a minor proportion (39, 3.9%) gave paracetamol. The majority of the respondents (87.0%) misused ibuprofen, whereas 84.6% misused paracetamol. A total of 16.5% of the respondents were aware that a child could die from fever. A total of 13.1% of the respondents did not see fever as always linked with teething. A total of 39.6% of the respondents had a good perception of fever. The respondents who had a good perception of fever were approximately nine times more likely to misuse either ibuprofen or paracetamol than those who had a poor perception (AOR = 8.5, 95% CI: 2.0–36.1). The respondents who were less than 30 years old were ten times less likely to misuse ibuprofen than those who were 50 years and above (AOR = 0.1; 95% CI: 0.04–0.3). Similarly, respondents who were between 30 and 39 years old were ten times less likely to misuse ibuprofen than those who were 50 years and above (AOR = 0.1; 95% CI: 0.05–0.3). CONCLUSION: The use of ibuprofen is more widespread than the use of paracetamol by mothers in febrile children, with the majority of mothers reporting side effects as deterrents. However, the misuse of both ibuprofen and paracetamol was noted to be high among these mothers. There was no marked difference in the use/misuse of ibuprofen or paracetamol among mothers who attended urban and rural hospitals.