# Parental awareness and practices regarding paracetamol use in children: A cross-sectional study from Pakistan

## TL;DR

This study from Pakistan shows that most parents lack proper knowledge about paracetamol use in children, increasing the risk of overdose and toxicity.

## Contribution

The study provides new insights into parental awareness of paracetamol use and its risks in a low-resource setting like Pakistan.

## Key findings

- Most parents use paracetamol as an antipyretic, but only 32.8% know it can be harmful in overdose.
- 75.8% of parents scored below 66.67% on a knowledge test, indicating insufficient understanding.
- Healthcare providers are the main source of information, but syrup is the most common form used.

## Abstract

Paracetamol is the one of the most widely administered drug as an analgesic and antipyretic due to its efficacy, safety, and over-the-counter (OTC) nature and is present in various pharmaceutical forms. Paracetamol usage in children is a global concern yet understudied in Pakistan. The present study was conducted to assess parental awareness regarding paracetamol usage and toxicity, highlighting critical public health risks and informing policy interventions aimed at lowering medication-associated toxicity in low-resource settings. This cross-sectional study aimed at assessing parental awareness in Sialkot city of Pakistan via a Urdu-language questionnaire (adapted from previous literature after pilot testing and expert review) was used as a tool to collect data. Questionnaire was distributed in six pediatric healthcare facilities. 450 parents were approached out of which only 420 gave consent and met inclusion and exclusion criteria. 2 responses were removed due to missing data. A total of 418 parents were interviewed, of which 67 % were mothers. Almost 99 % used it as an antipyretic, 18 % used it as an analgesic, and 81 %(n = 340) of the participants employed its use for the symptoms of illness (cough, flu, and vomiting). Most participants used paracetamol as a syrup. Health-care providers were the primary source of knowledge for paracetamol dosage. Only 32.8 % of participants were aware that a paracetamol overdose can cause harm. Approximately 75.8 % of the 418 participants scored below 66.67 % (4/6 questions) on the knowledge score and are considered to have insufficient knowledge. The current study highlights the lack of knowledge in parents regarding proper paracetamol usage which poses a significant risk of paracetamol poisoning. It underscores the importance of implementation of educational initiatives aimed at reducing the risks of toxicity and increasing awareness and knowledge regarding paracetamol among parents.