Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa

Nayyar, Gaurvika M. L.; Breman, Joel G.; Newton, Paul N.; Herrington, James E.

doi:10.1016/s1473-3099(12)70064-6

Cited by 341 publications

(311 citation statements)

References 44 publications

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“…[30] These poor quality products encourage drug resistance, compromise disease treatment, cause disease progression and hinder the chances of proper treatment. [31] More than 60% of the population practice self-medication, [28,29] with higher rates in the rural communities due to poverty and limited access to quality medicine. [32] Drug resistance is equally a nightmare, and parasite resistance to drugs like chloroquine, sulphadoxine pyrimethamine and ACT [2] and its derivatives has rapidly spread and affected all the ten regions in Cameroon.…”

Section: Case Managementmentioning

confidence: 99%

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Mbako¹

2017

CAJPH

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Abstract:Despite 66 percent reduction in mortality between 2000 and 2015, malaria remains a major global public health problem, affecting mostly Sub-Saharan Africa. Cameroon remains endemic to malaria, with about 41 percent suffering at least one episode of malaria, annual overall mortality of 30 to 35 percent and 67 percent childhood mortality. Cameroon government's subsidy on artemisinin combination therapy (ACT) for uncomplicated malaria, intermittent preventive treatment for pregnant women (IPTp), free distribution of insecticide treated bed nets (ITNs) to pregnant women and under-fives have been more of a top-down approach, with the affected communities mainly at the receiving end. Challenges of failed adherence to test results, drug and insecticide resistance, substandard and self-medication, low ITN ownership and utilisation have been identified, especially in the rural areas. This study reviews malaria prevention in Cameroon and proposes community based context-specific complementary interventions strategies that will promote community participation in prevention and mitigate the effects of poverty towards achievement of the sustainable development goals targets for malaria. The study involved an in-depth review of secondary data from electronic and non-electronic documents. Electronic search was done in Global Health, PubMed, governmental and non-governmental organisation websites, journals and google scholar. Non-electronic documents from the University of Leeds and World Health Organisation (WHO), Geneva libraries were also used. A conceptual framework on integrated community-based approach on intervention to prevent neglected tropical diseases and infectious diseases of poverty was adapted and used, while different intervention strategies were analysed. A total of 96 publications were eligible for inclusion. Analysis of the factors influencing malaria prevention in Cameroon, reveals that current measures alone are insufficient. Therefore, a combination of multiple delivery strategies using an integrated community-based approach is likely to be more effective in breaking the transmission cycle than single programme interventions. Concurrent implementation of community mobilisation through social groups and Village Development Committees, education on house screening, training of mothers and caregivers and health promotion through environmental management were recommended as the best and most feasible strategies to complement current interventions in Cameroon.

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Section: Case Managementmentioning

confidence: 99%

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Mbako¹

2017

CAJPH

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“…4 The situation is further compounded by counterfeit and substandard drugs, which form 10% of global medicines trade, 5 and 35% of all antimalarials in southeast Asia and sub-Saharan Africa are substandard. 6 The World Health Organization's (WHO) recommendation of artemether-lumefantrine as first-line therapy for acute falciparum malaria in endemic areas 7 has led to widespread use of this fixed-dose combination in tablets, dispersible tablets (DTs), and powders meant for reconstitution into pediatric suspensions (PSs). Some studies have reported methods for the quantification of only artemether 8,9 or lumefantrine 10,11 in pharmaceutical and biological matrices.…”

Section: Introductionmentioning

confidence: 99%

Artemether–Lumefantrine Concentrations in Tablets and Powders from Ghana Measured by a New High-Performance Liquid Chromatography Method

Debrah

Nettey

Miltersen

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. We developed and validated a new analytical method for the simultaneous quantification of artemether and lumefantrine in fixed-dose tablets and powders for reconstitution into pediatric suspensions (PSs). The method showed linearity (r 2 > 0.9947), precision (coefficient of variation < 2%), accuracy (deviation of mean from actual concentrations < 4%), and specificity (peak purities > 99%). The validated method was used to analyze 24 batches of fixed-dose tablets and PSs of artemether and lumefantrine. Of the samples, 23 were obtained using convenience sampling of commonly available brands within Accra in Ghana and one was obtained from Aarhus University Hospital. In all, 83.3% (confidence interval: 80-120%) passed for both artemether and lumefantrine contents, 16.7% failed by the U.S. Pharmacopoeia standards, 8.3% failed for one content, and 8.3% failed for both contents. All four products (16.7%) that failed were PSs, and two (8.3%) showed higher levels of artemether than prescribed (222% and 756%).

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“…Root cause analyses were not carried out thus it is impossible to tell the exact cause. The presence of falsified and sub-standard antimalarials, particularly, quinine in sub-Saharan Africa has been recognised [29], and in Ghana, sub-standard artemisinin-combination therapy have been sold in the open market [30]. The Ghana FDA has over the past 10 years taken active steps to improve detection of counterfeit medicines circulating in the country, and repeated surveys shows that the strong regulatory guidelines applied by the FDA are yielding results.…”

Section: Discussionmentioning

confidence: 99%

Adverse drug reactions in Ghanaian children: review of reports from 2000 to 2012 in VigiBase

Cliff-Eribo

Choonara

Dodoo

et al. 2015

Expert Opinion on Drug Safety

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ObjectiveTo describe adverse drug reactions (ADRs) reported for children aged 0-17 years in Ghana. MethodsPaediatric reports submitted by the Ghana National Centre for Pharmacovigilance to the World Health Organisation (WHO) Global ADR database, VigiBase up to December 2012 were extracted. The data was analysed for number of reports per year, types of reporters, and suspected ADRs and drugs. ResultsA total of 343 reports for children were received during the period. The drug classes most frequently reported were vaccines (115, 31%), antimalarials (106, 28%) and antibiotics (57, 15%). Nineteen of the top twenty individual drugs were anti-infectives. The most frequently reported ADRs were injection site infection, fever and rash. There were 23 deaths reported, and antimalarials were implicated in 12 cases. ConclusionsVaccines, antimalarials and antibiotics are the leading medicines reported to cause ADRs in Ghanaian children. There was a high mortality rate, with many of the deaths due to unexplained causes.

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Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa

Cited by 341 publications

References 44 publications

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Artemether–Lumefantrine Concentrations in Tablets and Powders from Ghana Measured by a New High-Performance Liquid Chromatography Method

Adverse drug reactions in Ghanaian children: review of reports from 2000 to 2012 in VigiBase

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