Indonesia said on Monday the number of child deaths from kidney failure or damage linked to harmful substances found in syrup medicines has risen to 195.

The Southeast Asian country has seen a spike in cases of acute kidney injury (AKI) since August, prompting a probe and subsequent ban on all liquid medicine sales.

More than 320 cases of AKI have been recorded in provinces across the country and 27 patients are still in hospital, health ministry spokesman Mohammad Syahril told a press conference.

Most of the children affected are under the age of five.

The new death toll is up from 133 deaths confirmed on October 21.

Tests found most of the deaths were caused by syrups containing excessive amounts of ethylene glycol and diethylene glycol, two compounds used in industrial products such as antifreeze, Syahril said.

Authorities have since been importing an antidote for AKI, with 246 vials obtained so far, the majority donated by Singapore and Australia, and the drug has shown significant results, the health ministry said.

Indonesia’s national food and drug agency last month named five syrups that contained dangerous levels of harmful substances and ordered the products be removed from the market and destroyed.

Police have launched an investigation into three local pharmaceutical companies and two of them have temporarily lost their licence to produce syrup medicines.

Before the recent spike, Indonesia typically recorded between two and five cases of AKI a month.

In West Africa, The Gambia reported 70 child deaths last month suspected to have been caused by imported syrup medicines.

The World Health Organisation has said it found an “unacceptable amount” of diethylene glycol and ethylene glycol in four Indian-made cough syrups and warned they could be linked to the deaths in the small African nation.

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