Knowledge and misconceptions of parents of children with attention-deficit hyperactivity disorder at a hospital in South Africa.

BACKGROUND: Parents' knowledge and misconception about attention-deficit hyperactivity disorder (ADHD) influences their children's access to care, its management and outcome. The study aimed to investigate parents' knowledge and perceptions of ADHD. METHODS: The cross-sectional survey of 79 parents of children (aged 5-17 years) with ADHD at a specialist child psychiatry clinic in KwaZulu-Natal Province, South Africa, consisted of a socio-demographic and clinical questionnaire, and the Knowledge of Attention Disorders Scale questionnaire, was carried out. RESULTS: Twenty-six (32.9%) parents consulted a traditional healer, of whom 84.6% did so before consulting a medical doctor, with 61.5% reporting that the healer suggested psychiatric referral. Most parents had some knowledge of their child's ADHD diagnosis but held various misconceptions about its treatment and associated factors: 92.4% believed that reducing sugar or food additives were effective to reduce symptoms; 78.5% that treatments focussing on punishment reduced the symptoms; 67.1% that prolonged use of stimulant medications leads to increased addiction (i.e. drug, alcohol) in adulthood. CONCLUSION: Many parents had misconceptions about ADHD's causes and treatment, some having consulted traditional healers, indicating the need to increase awareness among health practitioners to ensure timeous treatment access. A parent focussed psycho-education programme is required that provides information about causes, symptoms, treatment and prognosis.

Pharmacokinetics of orally administered phenylbutazone in African and Asian elephants (Loxodonta africana and Elephas maximus).

The pharmacokinetic parameters of phenylbutazone were determined in 18 elephants (Loxodonta africana and Elephas maximus) after single-dose oral administration of 2, 3, and 4 mg/kg phenylbutazone, as well as multiple-dose administrations with a 4-wk washout period between trials. After administration of 2 mg/kg phenylbutazone, mean serum concentrations peaked in approximately 7.5 hr at 4.3 +/- 2.02 microg/ml and 9.7 hr at 7.1 +/- 2.36 microg/ml for African and Asian elephants, respectively, while 3 mg/kg dosages resulted in peak serum concentrations of 7.2 +/- 4.06 microg/ml in 8.4 hr and 12.1 +/- 3.13 microg/ml in 14 hr. The harmonic mean half-life was long, ranging between 13 and 15 hr and 39 and 45 hr for African and Asian elephants, respectively. There was evidence of enterohepatic cycling of phenylbutazone in Asian elephants. Significant differences (P < 0.0001) in pharmacokinetic values occurred between African and Asian elephants for clearance (27.9 and 7.6 ml/hr/kg, respectively), terminal half-life (15.0 and 38.7 hr, respectively), and mean residence time (22.5 and 55.5 hr, respectively) using 2-mg/kg dosages as an example. This suggests that different treatment regimens for Asian and African elephants should be used. There were no apparent gender differences in these parameters for either elephant species.