Response: Accidental Potassium Bromate Poisoning Causing Acute Renal Failure

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Working Paper 36 - Information Technology and the Challenge of Economic Growth in Africa

The recent advances in information technology are becoming central to the process of socio-economic development. Information technology offers new ways of exchanging information, and transacting business, changes the nature of the financial and other service sectors and provides efficient means of using the human and institutional capabilities of countries in both the public and private sectors. The world is rapidly moving towards knowledge-based economic structures and information societies, which comprise networks of individuals, firms and countries that are linked electronically and in interdependent relationships. In an increasingly globalized economy, information technology is one of the key determinants of competitiveness and growth of firms and countries. Firms are becoming more competitive on the basis of their knowledge, rather than on the basis of natural endowments or low labor costs. It is becoming increasingly apparent that the role of traditional sources of comparative advantage (a large labor force and abundant natural resources) in determining international competitiveness is diminishing. The competitive and comparative advantages of countries are gradually being determined by access to information technology and knowledge. The comparative advantage that now counts is man-made, engineered by knowledge through the application of information. Since man-made comparative advantage can only be acquired by knowledge and brainpower, the newly emerging knowledge-based economic structures have far reaching implications with regard to labor markets and the roles of technical education, human capital formation and research and development in the process of economic growth. The evolution of the knowledge-based economy is expected to result in increasing the demand for skilled labor and reducing the employment prospects of unskilled labor. And within economies, enterprises would succeed only to the extent that their employees can access and use information and knowledge effectively. Information technology does not only determine the market share and profitability of individual companies in tomorrow's global economy, but it also has a huge impact on future generations of workers and on a country's economic prospects. What are the implications of information technology for the relative fortunes of nations? Countries that invest in and adopt information technology quickly will move ahead and those that fail to rapidly adopt information technology will be left behind. The views on the possible impact of the information revolution on African countries can be grouped in two opposing schools of thought. The first school predicts that as African countries incur an increasing 'technological deficit' the welfare gap between them and the industrialized world would increase. This school stresses that Africa risks further reduction in its ability to generate the resources necessary to accelerate its growth rate and reverse the trend of increasing poverty. On the other hand, the second school believe that information technology may actually help reduce the income gaps between rich and poor countries. In the words of Negroponte (1998): "the Third World five years from now may not be where you think it is. There have been many theories of leapfrog development, none of which has yet survived the test of time. That's about to change". The basic issue separating the two schools with regard to the impact of information technology on African countries is the question of whether Africa and other developing regions could, in the first place have adequate access to the global information Infrastructure, and hence to the information technology age. The prediction of the first school stems from the notion that, starting from an initial position of poverty, African countries would not be able to finance the investments in information infrastructure and computer hardware and software required to access the information technology age. This would, in turn, mean that they would risk increased marginalization in the global economy with severe competitive disadvantage for their goods and services, and hence for their development prospects. The prediction of the second school is based on the argument that the information technology, itself, would provide the means for countries to turn their disadvantages into advantages; adjust to the new ways of doing business; and, put in place the required infrastructure of telecommunications and information systems. This paper reviews Africa's development challenges in an increasingly information and knowledge-based global economy. It outlines the roles of knowledge and information technology in addressing these challenges and also discusses the strategies and policies that Africa and its development partners particularly the African Development Bank could adopt to accelerate the process of integrating the region into the emerging global information system. The paper is organized in five sections. Following this introduction, the next section examines the major developmental challenges facing Africa and what role information technology could play in overcoming them. Section III outlines the policies that would need to be adopted by African countries to improve their information accessibility and examines the initiatives taken by African countries in this domain. Section IV examines the role that could be played by the African Development Bank Group. The conclusion of the paper is provided in the last section.

Working Paper 42 - Global Financial Crisis: Implications and Lessons for Africa

The global financial system has witnessed rapid growth and substantial structural change duringthe last ten years leading to globalisation of financial markets. The integration of financial markets hasaccentuated the rapid flow of capital across borders as well as magnified the contagious effects offinancial crisis with wide implications for transmission of financial policies on the domestic economy andinternationally. The recent financial crisis which originated in East and South East Asia (hereafter Asia)and transformed into a global crisis is a case in point. At no time since the depths of the LDC debt crisisof the 1980s has the outlook for emerging markets appeared so bleak. Economic outlook in Asia andits financial crisis appears destined to last well into 1999, and the world faces the prospects of weakergrowth. This paper reviews recent trends in global financial markets, in particular the expanding financialturmoil, which was been triggered by the Asian crisis. It examines the major factors behind financialturmoil and its impact on African countries. The paper also explores the main lessons and policyimplications for African countries. Following this introduction, Section II gives a brief account of thedynamics of the crisis—its origin and channels of transmission from one region to another. Section IIIexamines the main causes of the crisis and Section IV provides a discussion of the qualitative andquantitative impact of the crisis on African countries. The main lessons and policy implications are drawin Section V. Section VI provides the concluding remarks.

Pathophysiological changes that affect drug disposition in protein-energy malnourished children

Protein-energy malnutrition (PEM) is a major public health problem affecting a high proportion of infants and older children world-wide and accounts for a high childhood morbidity and mortality in the developing countries. The epidemiology of PEM has been extensively studied globally and management guidelines formulated by the World Health Organization (WHO). A wide spectrum of infections such as measles, malaria, acute respiratory tract infection, intestinal parasitosis, tuberculosis and HIV/AIDS may complicate PEM with two or more infections co-existing. Thus, numerous drugs may be required to treat the patients. In-spite of abundant literature on the epidemiology and management of PEM, focus on metabolism and therapeutic drug monitoring is lacking. A sound knowledge of pathophysiology of PEM and pharmacology of the drugs frequently used for their treatment is required for safe and rational treatment. In this review, we discuss the pathophysiological changes in children with PEM that may affect the disposition of drugs frequently used for their treatment. This review has established abnormal disposition of drugs in children with PEM that may require dosage modification. However, the relevance of these abnormalities to the clinical management of PEM remains inconclusive. At present, there are no good indications for drug dosage modification in PEM; but for drug safety purposes, further studies are required to accurately determine dosages of drugs frequently used for children with PEM

A Note on “Malaria at Parturition in Nigeria: Current Status and Delivery Outcome”

We read the recent article by (Mokuolu et al. 2009) with keen interest and would like to congratulate them for a job well done. However, we would like to raise a few points relating to the limitations of the study

Financial Integration in the West African Monetary Zone

This paper highlights the importance of the WAMZ programme, which seeks financial integration through five main components. It further assesses the extent of integration in the financial sector based on the benchmark stipulated under WAMZ Action Plan of 2005, referred to as the Banjul Declaration. The paper also provides evidences on the extent to which financial indicators show how far or nearer to having a seamless financialsystem, and suggest areas requiring policy intervention

Medication history documentation in referral letters of children presenting at the emergency unit of a teaching hospital in Lagos, Nigeria

Background: Medical literature has demonstrated that referral hospitals often receive inadequate information about the care and medications their patients received from referring hospitals.Objectives: This study aimed to assess the completeness of referral letters, especially the medication history, for patient presenting at the children emergency room of a teaching hospital in Lagos, Nigeria.Methods: A pro forma form was developed to obtain from the referral letters the demographic information of children referred to the emergency room of the Lagos University Teaching Hospital (LUTH), Idiaraba, over a period of three months. The nature of the referring centre, tentative diagnoses made at the referring centre, duration of illness prior to referral, vital signs and  hysical examination findings, investigation results, and treatment given were also extracted from the letters. In addition, we extracted from the letters the name, dosage, frequency and duration of use of medicines administered at the referring centres. Parents were also interviewed about the details of medicines used prior to presentation of their child at the referring centres.Results: Among those referred with a letter, 100 patients met the inclusion criteria and constituted those evaluated in this study. Most of the patients were referred from general hospitals (31%), another tertiary hospital (29%), and private hospitals/clinics (24%). Gender (30%) and tentative diagnoses (12%) were omitted in the referral letters. However, information about the weight (82%), vital signs (57%), physical examination findings (44%), treatment given (92%), and medication history (71%) were much more omitted in the referral letters.Conclusion: Medication history as well as many other data points is infrequently reported in referral letters to a tertiary care hospital in Lagos, Nigeria. Standard referral guidelines may be useful to improve documentation of medication history.Keywords: Medication, History, Referral letters, Children, Emergency unit, Tertiary hospita

Sources of drug information and their influence on the prescribing behaviour of doctors in a teaching hospital in Ibadan, Nigeria

Background: Pharmaceutical drug promotion is a means of informing health professionals about new drugs. The approach is often times unethical and inappropriate and may promote irrational prescribing. Dearth of information on impact of pharmaceutical drug promotion on prescribing behaviour of doctors in developing African countries has necessitated this study. We therefore aimed to determine the sources of drug information for doctors working in a teaching hospital in Nigeria and to assess the self-reported impact of the sources on their prescribing behaviour. Methods: A total of 163 doctors working at the University College Hospital (UCH), Ibadan in Nigeria were evaluated with a questionnaire for their demographics and sources of drug information. For doctors who relied on drug promotion, they were asked to self-report and self-rate their opinion on extent of interactions with pharmaceutical companies as well as how such interactions had impacted on their prescribing behaviour. Apart from the demographics, each question was evaluated with a typical five-level Likert item. Data analyses were with simple descriptive statistics. Results: Of the 400 doctors working at UCH, only 40.8% participated in the study. Drug information was sourced from colleagues (161, 98.8%), reference books (158, 96.9%), pharmaceutical sales representatives-PSRs (152, 93.2%), promotion materials (151, 92.6%), scientific papers/journals/internet (149, 91.4%), and drug promotion forum/product launches (144, 88.3%). Each source was highly utilized but there was no wide variation in their pattern of use. According to the self-report of over a half of the respondents, PSRs was an accurate and reliable drug information resource; PSRs increased their awareness of the promoted drugs; and their prescribing behaviours were influenced by information from PSRs. Conclusion: Respondents tend to rely on a broad range of drug information resources which include potentially inappropriate resources such as PSRs. Since this study was based on self-report, the influence of drug information resources reported by the respondents on their prescribing behaviour may have been underestimated. Measures should be taken to minimize interactions between PSRs and the respondents.Key words: Drug, prescription, information source, promotion, pharmaceutical company, influence, doctors, Nigeri