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Évaluation de risques des événements indésirables liés à l’usage des plantes médicinales chez les enfants atteints de maladies hématologiques et cancéreuses

Assessment of risk of adverse events associated with the use of herbal medicines in children with hematological diseases and cancer

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Phytothérapie

Résumé

Pour évaluer la prévalence des événements indésirables (EI) liés à l’utilisation des plantes médicinales (PM) et inventorier les PM les plus utilisées chez les enfants (moins de 16 ans) atteints de maladies hématologiques et cancéreuses, nous avons mené une étude auprès de 404 patients (ou de leurs tuteurs) pendant quatre mois au Centre d’Hématologie-Oncologie Pédiatrique (CHOP) de Rabat. Cette étude a été réalisée à l’aide d’un questionnaire de 10 items et avec l’objectif de collecter le maximum d’informations concernant le patient et les PM utilisées dans les maladies hématologiques et cancéreuses. Cette enquête a montré que 14,9% des patients ont eu recours à l’usage des PM, tous ceux qui ont utilisé les PM ne divulguent pas l’information à leur médecin traitant, avec un sex-ratio de 1,4. Parmi les patients interrogés, utilisant les PM, on note que 9,4% ont présenté des EI. L’analyse des résultats a montré que la néphrite tubulointerstitielle représente l’IE le plus fréquent (3,2%), suivie par la toux et le rhume (0,5%), la diarrhée (0,2%) et les vomissements (0,2%). Ces résultats ont montré que l’évolution est favorable dans 5 % des cas. Parmi les PM utilisées par les patients, certaines sont incriminées dans l’apparition des EI, telles Nigella sativa L. (5%) et Aristolochia longa L. (2,3%). Le recours aux plantes médicinales en tant que alternative médicale au CHOP représente une issue incontournable pour la majorité des patients, les PMsont utilisées en première intention dans 3,9% des cas, en concomitance avec les traitements médicamenteux dans 85%des cas et en complément au terme de la thérapeutique médicale dans 11,1%. L’intérêt de la sensibilisation de familles des patients et des oncologues aux risques des EI liés à l’usage des PM reste primordial pour une prise en charge optimale des patients.

Abstract

To better assess the prevalence of adverse events (AEs) related to the use of medicinal plants (PM) and inventory the most used in children PM (under 16 years) with hematological diseases and cancer, we conducted a study with 404 patients (or their guardians) for four months at the Pediatric Hematology -Oncology Centre (CHOP) in Rabat. This study was performed using a 10-item questionnaire through which we aim to gather as much information as possible on patients and PM used in hematological diseases and cancer. The survey showed that 14.9% of patients have resorted to the use of PM, all those who have used the PM does not disclose the information to their physician, with a sex ratio of 1.4. Among interviewed patients, using PM, we note that 9.4% had AEs. Analysis of the results showed that tubulo-interstitial nephritis is the most common IE (3.2%), followed by cough and cold (0.5%), diarrhea (0.2 %) and vomiting (0.2%). These results showed that the outcome is favorable in 5% cases. Among the PM used by patients, some of them are involved in adverse reactions, Nigella sativa L. in 5% and Aristolochia longa L. in 2.3%. The resort to medicinal plants as an alternative is a major issue for most of patients, herbals are used in first line in 3.9% of the cases, concomitantly in 85% and as a complementary at the end of the medical therapeutic in 11.1%. The sensitization of patients, families and physicians is of a major importance for an optimal management of patients.

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Authors and Affiliations

  1. Faculté des sciences, Université Mohammed V-Agdal, Rabat, Maroc

    A. Chebat & A. Kahouadji

  2. Centre antipoison et de pharmacovigilance du Maroc, Rabat, Maroc

    A. Chebat, S. Skalli, R. Benkirane & R. Soulaymani

  3. Centre d’hémato-oncologie pédiatrique (CHOP), Rabat, Maroc

    M. Khettab

  4. Faculté de médecine et de pharmacie, Rabat, Maroc

    R. Soulaymani & M. Khettab

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  1. A. Chebat
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  2. S. Skalli
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  3. R. Benkirane
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  6. A. Kahouadji
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Correspondence to A. Chebat.

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Chebat, A., Skalli, S., Benkirane, R. et al. Évaluation de risques des événements indésirables liés à l’usage des plantes médicinales chez les enfants atteints de maladies hématologiques et cancéreuses. Phytothérapie 13, 176–184 (2015). https://doi.org/10.1007/s10298-014-0912-4

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