A joint probe conducted by the Centers for Disease Control and Prevention (CDC) of the US and the Gambian health authorities on a made-in India cough syrup has shown there was a strong link between the death of many children in Gambia and the consumption of the made-in-India cough syrups that were allegedly contaminated.
A CDC report released on Friday stated, “This investigation strongly suggests that medications contaminated with Diethylene Glycol [DEG] or Ethylene Glycol [EG] imported into the Gambia led to this Acute Kidney Injury (AKI) cluster among children.”
As per the report, “Patients with DEG poisoning can experience a range of signs and symptoms, including altered mental status, headache, and gastrointestinal symptoms; however, the most consistent manifestation is AKI, characterized by oliguria (low urine output) or anuria, progressing over 1-3 days to renal failure (indicated by elevated serum creatinine and blood urea nitrogen).”
CDC stated that they were contacted by Gambia’s Ministry of Health (MoH) to assist in characterising the illness (multiple cases of Acute Kidney Injury and deaths in children), describing the epidemiology, and identifying potential causal factors and their sources in August last year.
The report also said that in past DEG outbreaks, manufacturers have been suspected of substituting DEG in the place of more expensive, pharmaceutical-grade solvents.
“Among reports of AKI associated with DEG-contaminated medical products, this is the first in which DEG-contaminated medications were imported into a country, rather than being domestically manufactured,” it said.
In October 2022, the World Health Organization (WHO) had issued an alert stating that the four cough syrups being supplied to Gambia by the Indiabased Maiden Pharmaceuticals Ltd were of substandard quality and claimed that they were linked to the death of many children in Gambia.
Maiden Pharma has a large international presence and has its supply chain to multiple countries in Africa, Asia, Eastern Europe, the Middle East and Russia. The company was established in 1990 and within three decades it has attained a sound production line and established itself in the field of research and development.
The four drugs are Promethazine Oral Solution BP, KOFEXMALIN Baby Cough Syrup, MaKOFF Baby Cough syrup and MaGrip n Cold Syrup, which are licenced to Maiden Pharma for export purposes only.