エチオピアの小児患者における医薬品関連問題とその関連要因：系統的レビューとメタアナリシス

Medication-related problems are a significant global public health concern, with children being particularly vulnerable due to factors like weight-based dosing and immature organ function. In low-resource settings like Ethiopia, the burden is suspected to be high, but a comprehensive national estimate has been lacking.

This systematic review and meta-analysis aimed to determine the pooled prevalence of medication-related problems and their associated factors among paediatric patients in Ethiopia.

A comprehensive search was conducted across PubMed, Google Scholar, Science Direct and Hinari-Research4Life and manual reference search from 1 to 10 September 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting data on medication-related problems (including medication errors, adverse drug reactions and drug therapy problems) in Ethiopian children were included. Data extraction and quality assessment were performed by independent reviewers. Heterogeneity was assessed using I² statistics; moderate heterogeneity (I²=39.4%) was observed and a random-effect model was used. Subgroup analysis and meta-regression were applied to explore the source of heterogeneity.

Out of 3435 initially identified articles, 21 hospital-based studies involving 5969 paediatric patients were included. The pooled prevalence of medication-related problems across these studies was 53% (95% CI 45% to 61%) with a pooled incidence rate of 1.17 medication-related problems per child and a moderate level of heterogeneity. The pooled prevalence of dosing error was 37.4%. Additionally, 51% of children had comorbid conditions and 42% were exposed to polypharmacy. Both polypharmacy (≥5 medications: pooled OR=1.32; 95% CI 1.13 to 1.52) and the presence of comorbidity (pooled OR=1.32; 95% CI 1.02 to 1.61) were significantly associated factors of medication-related problems.

More than half of the paediatric patients in Ethiopia experience medication-related problems. Polypharmacy and comorbidities are major contributing factors. Therefore, comprehensive medication review and monitoring are needed to mitigate this substantial burden.