Michael J. Ssali
12 October 2008
Masaka — It has often happened that patients have received medications from health workers or herbalists and ended up suffering from adverse effects of those very medications from which they hoped to get relief. The adverse effects could be blindness, loss of limbs, skin rushes and itches or other problems.
Ms Helen Ndagije, head of the drug information department, told a conference of pharmacists, health workers, and local leaders from the districts of Masaka, Rakai, Kalangala, Ssembabule and Lyantonde October 3 that the problem could not always be blamed entirely on the manufacturer of the drugs or the pharmacist who imported and dispensed them. "While in some cases they are the culprits, we still have cases of incompetent medical personnel who may prescribe the wrong dose or apply the drug through the wrong route. We also have cases of patients that may not follow the doctors' instructions as they use drugs and end up with adverse effects.
The conference took place at Uganda Cares Clinic located within Masaka Regional Referral Hospital. The National Drug Authority (NDA) has established a mechanism known as 'pharmacovigilance' to monitor drugs and to ensure their safe use. Pharmacovigilance, according to a paper presented by Dr Patrick Banura at the conference, is the science of collecting, monitoring, researching, assessing and evaluating information from health care providers and patients on the adverse effects of medications, biological products, herbs and traditional medicines with a view to identifying new information about hazards associated with medicines and preventing harm to patients.
At the conference Masaka Regional Referral Hospital was declared a pharmacovigilance centre. All health workers, veterinary doctors and patients in the Masaka region who use drugs and notice adverse effects are encouraged to report cases to the centre.
Dr Banura, who is attached to Masaka Regional Referral Hospital, said that when doctors prescribe medicine the drugs sometimes cause undesirable side effects to the treated client and this makes pharmacovigilaance important.
Dr Asuman Lukwago, a physician at the same hospital, had earlier complained, "We have cases of pharmacists selling fake or expired drugs."
Dr Banura noted that an estimated 1.5 million people visit hospitals, dispensaries and clinics operating under Masaka Regional Referral Hospital all of whom will be observed for adverse drug reactions. "Our hospital is also a medical school these days, training doctors under Kampala International University, and so I am sure it is the best place for hosting the pharmacovigilance centre,"
So far, the NDA had only one such a centre located at the Drug Information Centre, on Lumumba Avenue in Kampala, which became operational in 2005 according to Ms Ndagije. She said that more pharmacovigilance centres are to be opened in Gulu and Lira in northern Uganda.
She said that the other aim of establishing such centres is to monitor the quality of drugs on the Ugandan market and to ensure that the drugs administered to patients all over Uganda are entirely safe. The centres will also collaborate with World Health Organisation Monitoring Centre at Upsala in Sweden.
Meanwhile, a board member of NDAm Dr Winifred Tumwikirize said that the key people in monitoring the adverse effects of drugs on patients are the patients themselves, the nurses, the clinicians, the midwives, and the doctors.
"Pharmacovigilance should not be regarded as something really new. It is part and parcel of our clinical care," she said. "When we dispense or subscribe the drugs oftentimes we know the common expected adverse drug reactions which could be a strange feeling in the ears, or itching. We ought to ask routinely what the patient feels after using the drug for a day or so. We don't want to cure the patient of the illness and then see him die as a result of the adverse effects of the drug that was used, expecting to cause relief to him."
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