Dear CHIFA colleagues,
I want to share something I got wrong, because I suspect it is not only my problem.
I run a free site that answers parents' questions about their sick child from published paediatric guidelines, in eight languages, with the source shown beside
every sentence. Part of it is a dose calculator by weight for paracetamol and ibuprofen. Until this week it offered a list of the bottle strengths I knew about, and the parent picked theirs.
Then I read the EFDA list of medicines allowed over the counter in Ethiopia, and found that paracetamol drops there are 100 mg/5 mL. In Spain, Portugal and India, drops are 100 mg/mL —
five times stronger. My list only had the second one. A parent in Addis Ababa holding their bottle would read "drops" on the label, find "drops 100 mg/mL" on my page, and give five times the volume that bottle needs.
I fixed it, and then made it worse: the new, weaker strength sorted to the top of the list, so a
parent in Spain with the concentrated drops could have taken the first line and overdosed by
five. I found that by looking at the page the way a parent looks at it, not by reading my code.
All my tests were green.
What I have done since is stop trying to know every bottle. A 2025 study of national essential
medicines lists counts 28 different paracetamol formulations worldwide. So the calculator now
has a field where the parent types what their own bottle says, in mg per 5 mL or mg per mL, and
that line is shown first. The milligrams are still computed from the child's weight by a fixed
published table; the typed number only converts to millilitres, so a mistyped concentration
changes the volume and not the dose. Out of a plausible band it refuses to give a number and
asks them to check whether the bottle says per mL or per 5 mL.
Two questions for this forum, and they are the reason I am writing:
1. Is this confusion something you see in practice? I only found it because I went looking for
Ethiopian brand names and found strengths instead.
2. I have since read the national essential medicines lists of Ethiopia, Rwanda, Mozambique
and DR Congo myself. Madagascar's list gives paracetamol syrup as 125 mg/mL, which would be
five times the usual strength, so I have not added it: I cannot tell whether it is a real
product or a typo. If anyone here works in Madagascar, or in Angola or Malawi, whose lists I
could not read, I would be grateful for a pointer. I will only add a country when I can read
its own document; I am not willing to guess.
The site is pedibot.xyz, free, no account, no advertising, and it works on a phone with no
signal after the first visit. No clinician has reviewed any of it and I am not a doctor, which
is the main thing wrong with it and the reason I am asking here.
Thank you,
Nicolas Beca
CHIFA profile
Nicolás Beca is the founder of PediBot (pedibot.xyz), a free child-health information service for parents that answers only from published guidelines, Seville, Spain. pedibot.aiATgmail.com