Suspected Cause of Acute Kidney Injury: Trends in Indonesia's Ethylene Glycol Imports from India

The Indonesian Ministry of Health (Kemenkes) has revealed the presence of ethylene glycol in several cough syrups and paracetamol syrups. This compound is suspected to be linked to the mysterious cases of acute kidney injury in children.

"Indeed, a toxic compound, one of which is ethylene glycol, has been found, but a conclusion on its relationship to acute kidney injury cannot yet be drawn," said Siti Nadia Tarmizi, Head of the Kemenkes' Bureau of Communication and Public Services, as quoted by *Kompas.com* on Wednesday (19/10/2022).

Ethylene glycol is a chemical compound found in four cough syrup products manufactured by Maiden Pharmaceutical Ltd, India. These cough syrups caused dozens of children in Gambia to die from acute kidney failure after consuming them.

The four cough syrups in question are Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup, and Magrip N Cold Syrup. In Indonesia, Nadia said, the ministry is still investigating and further tracing the findings.

Indonesia also imports ethylene glycol from India. This product falls under HS 290531, namely acyclic alcohols, diols, and ethylene glycol. According to UN Comtrade data, the value of ethylene glycol imports reached US$5,670 or approximately Rp 88.59 million in 2021 (Rp15,626/US$).

This import value decreased by 64.41% year-on-year (yoy). In 2020, the value of ethylene glycol imports reached US$15,933 million.

Over the past five years, Indonesia's ethylene glycol imports from India have been fluctuating. The highest value was recorded in 2018 at US$49,383, while the lowest was in 2019 at US$5,033.

With the increase in cases of acute kidney injury in children, the government has ordered healthcare facilities, healthcare workers, and pharmacies to temporarily stop dispensing syrup medicines suspected of containing ethylene glycol.