Is diagnosing patients with organic acidurias and aminoacidopathies enough? Conundrums of a low middle-income country

Hafsa Majid, Lena Jafri, Zeba Zulfiqar Ali, Bushra Afroze

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: This study was done to determine the factors responsible for non-treatment of inherited metabolic disorders (IMDs) requiring food for special medical purposes (FSMPs) in Pakistan. Methods: A descriptive cross-sectional study was conducted by Departments of Pediatrics & Child Health and Pathology & Laboratory Medicine, Aga Khan University. Patients diagnosed with IMDs from January 2013 to December 2016 requiring FSMPs were surveyed after a year of initial diagnosis to collect the details of treatment advised, mortality status, and reasons of non-treatment, including not prescribed by physician, non-acceptance by family, non-availability or non-affordability. Results: Over four years period, 311 patients were identified with IMDs; Median age of patients was 1.0 yrs (0.0.2-3.65) with 54% (n=168) being male. Of the total 38.2% (n=119) required FSMPs, 9% (n=28) patients were excluded due to unavailability of diagnostics information. Parents of 58 patients requiring FSMPs out of 119 participated in survey. The leading causes of non-treatment were, FSMPs not prescribed by physicians (n= 30, 51.7%) followed by non-affordability (n=23, 39.6%), families’ unacceptance in (n=9, 18%) patients, non-availability of FSMPs (n=2, 3.4%) and early death of patient (n=1, 1.7%). Conclusion: The main factors responsible for non-treatment of FSMPs requiring IMDs were non-prescription by physician and non-affordability.

Original languageEnglish
Pages (from-to)1876-1901
Number of pages26
JournalPakistan Journal of Medical Sciences
Volume37
Issue number7
DOIs
Publication statusPublished - 6 Sept 2021

Keywords

  • Food for special medical purposes
  • Inherited metabolic disorder
  • Non-affordability
  • Non-prescription
  • Pakistan
  • Survey
  • Treatment

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