One in 10 Malaria Drugs is of Poor Quality

A new research released recently has indicated that substandard medicines are more prevalent than fakes in the world’s most malaria-burdened country, Nigeria.

A rigorous analysis of more than 3,000 anti-malaria drugs purchased in Enugu, Nigeria found 9.3 per cent to be of poor quality, according to a new research published in PLOS ONE.

Researchers found 1.2 per cent of the samples to be falsified and 1.3 per cent to be degraded, but raised bigger concerns about 6.8 per cent being of substandard manufacture, leaving patients at risk of not receiving the correct treatment dose and potentially contributing to the development of resistance to the main drug used to treat malaria.
The drug quality team of the Artemisinin-based Combination Therapy (ACT) Consortium at the London School of Hygiene and Tropical Medicine analysed 3,024 anti-malaria drugs containing artemisinin (the component that makes malaria treatment effective) from Enugu Metropolis, South-east Nigeria, which has a population of 3.3 million.

Nigeria is the single most heavily malaria-burdened country in the world, with 48 million malaria cases and 180,000 deaths per year.

Dr Harparkash Kaur, from the London School of Hygiene and Tropical Medicine, who led investigators of the drug quality programme of the ACT Consortium, said:

“Although these results raise concerns, they are reassuring in comparison with previous reports that found that more than 35 per cent of antimalarias in sub-Saharan Africa failed chemical content analysis – in other words, were poor quality.

“This may be because those reports predominantly used a ‘convenience’ approach to select samples for analysis, which may not be representative of the places where patients buy their medicines.”

The team purchased medicines from 421 outlets in Enugu including pharmacies, patent medicine vendors, and public health facilities.

In addition to ‘convenience’ sampling, which lacks systematic guidance on which outlets to sample from, samples were also bought from a representative sample of outlets.

Two approaches were used in the representative sampling: a covert approach, using “mystery clients” in which researchers pretended to be patients with malaria, or their relatives, asking to buy medicines; and an “overt” approach, where…

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