Substandard anti-malarial drugs in Burkina Faso

Tipke, Maike; Diallo, Seydou; Coulibaly, Boubacar; Störzinger, Dominic; Hoppe-Tichy, Torsten; Sié, Ali; Müller, Olaf

doi:10.1186/1475-2875-7-95

Cited by 62 publications

(58 citation statements)

References 25 publications

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“…In the current study, 17 samples were detected non-compliant out of the 40 analysed giving a non-compliance rate of 42.5%. This result correlates with that of Diallo conducted in Burkina Faso with a rate of 42% [18] and that of Akole in Benin which came up with 24 samples over 53 with a non-compliance rate of 45% [19]. Nigeria and Thailand, have achieved 43% of non-compliance for the samples from Nigeria and 50% for those from Thailand.…”

Section: Discussionsupporting

confidence: 85%

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Baba-Moussa¹,

Bonou²,

Ahouandjinou³

et al. 2015

ABB

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Malaria is a parasitic disease caused by the bite of female Anopheles mosquito and particularly affects the tropical areas of the world. According to national statistics it is the leading cause of consultations and hospitalizations. Nowadays, despite the surveillance systems for efficient malaria control and access to generic drugs, Benin is witnessing an increased development of illicit drug markets with a large part of the population going towards such markets. However, this is not without adverse impact on the health of individuals, as well as, the economic status of the country. Therefore, the situation needs to be seriously considered by policy makers at various levels, health professionals but also the entire international community in order to thwart this scourge. * Corresponding author.F. Baba-Moussa et al. 638Regarding the aforementioned situation, the current study was undertaken aiming to perform a quality control of selected antimalarial drugs of the illegal market in Porto-Novo city. Therefore, 40 antimalarial batches were randomly collected in the illicit drug market and submitted to analytical tests such as: macroscopic examination (a visual and critical examination); mass uniformity test; disintegration test; identification test and active ingredients' content measurement. At the end of the study, the percentages of non-compliance is 97.5%, 5%, 15% and 27.5%, respectively for the content uniformity tests, disintegration, identification and assay. Over-all, 42.5% of noncompliance was recorded. The findings of this study prove that street vended drugs offer no guarantee of good quality and pose a threat to the health of populations. Also, the rate of non-compliance denotes a flaw in the security of the drug distribution system.

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Section: Discussionsupporting

confidence: 85%

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Baba-Moussa¹,

Bonou²,

Ahouandjinou³

et al. 2015

ABB

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“…Those studies had been carried out in rural settings where malaria transmission is high and seasonal, mainly occurring during the months of August–December [17, 18, 22]. In Burkina Faso, SP had been used as second-line treatment before 2005, but was increasingly used as a first-line drug after chloroquine was discontinued in 2005, when artemisinin combination therapy (ACT) was not yet readily available [23, 24]. Therefore, those different reports suggest either a variation in SP pressure according to study areas or differing access to ACT [18].…”

Section: Discussionmentioning

confidence: 99%

Recent uptake of intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine is associated with increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso

Cissé

Awandare

Soulama

et al. 2017

Malar J

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BackgroundThe impact of sulfadoxine–pyrimethamine (SP) used as intermittent preventive treatment during pregnancy (IPTp-SP) on mutant parasite selection has been poorly documented in Burkina Faso. This study sought first to explore the relationship between IPTp-SP and the presence of mutant parasites. Second, to assess the relationship between the mutant parasites and adverse pregnancy outcomes.Methods From September to December 2010, dried blood spots (DBS) were collected during antenatal care visits and at delivery from 109 pregnant women with microscopically confirmed falciparum malaria infection. DBS were analysed by PCR–restriction fragment length polymorphism (PCR–RFLP) for the polymorphisms at codons 51, 59, 108, and 164 of the Pfdhfr gene and codons 437 and 540 in the Pfdhps gene.ResultsBoth the Pfdhfr and Pfdhps genes were successfully genotyped in 92.7% (101/109) of the samples. The prevalence of Pfdhfr mutations N51I, C59R and S108N was 71.3, 42.6 and 64.4%, respectively. Overall, 80.2% (81/101) of samples carried the Pfdhps A437G mutation. None of the samples had the Pfdhfr I164L and the Pfdhps K540E mutations. The prevalence of the triple mutation N51I + C59R + S108N was 25.7% (26/101). The use of IPTp-SP was associated with a threefold increased odds of Pfdhfr C59R mutation [crude OR 3.29; 95% CI (1.44–7.50)]. Pregnant women with recent uptake of IPTp-SP were at higher odds of both the Pfdhfr C59R mutation [adjusted OR 4.26; 95% CI (1.64–11.07)] and the Pfdhfr intermediate-to-high resistance, i.e., ≥ 2 Pfdhfr mutations [adjusted OR 3.45; 95% CI (1.18–10.07)]. There was no statistically significant association between the presence of the Pfdhfr intermediate-to-high resistance and parasite densities or both maternal haemoglobin level and anaemia.ConclusionThe data indicate that despite the possibility that IPTp-SP contributes to the selection of resistant parasites, it did not potentiate pregnancy-associated malaria morbidity, suggesting the continuation of SP use as IPTp in Burkina Faso.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1695-1) contains supplementary material, which is available to authorized users.

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“…In Côte d'Ivoire, ASAQ and AL have been recommended respectively in first-and second-line treatment since 2005 following earlier studies. [20][21][22] But continued use of amodiaquine or artesunate monotherapies, persistence of substandard ACTs in the private sector, [10][11]23 and resistance to artesunate and/or amodiaquine 24 may jeopardize the future use of ASAQ and AL as an effective artemisinin-based combination therapy. The emergence of artemisinin resistance may also compromise the future use of artesmisinin derivatives as potential alternatives to SP for IPTp.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the efficacy of first-line antimalarial drugs after 5 years of deployment by the National Malaria Control Programme in Côte d'Ivoire

Offianan¹,

Assi²,

A³

et al. 2011

OAJCT

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Background:The emergence of artemisinin resistance has raised concerns that the most potent antimalarial drug may be under threat. Artesunate + amodiaquine (ASAQ) and artemetherlumefantrine (AL) are respectively the first-and second-line treatments for uncomplicated falciparum malaria in Côte d'Ivoire. A comparison of the efficacy and safety of these two drug combinations was necessary to make evidence-based drug treatment policies. Methods:In an open-label, non inferiority, randomized, controlled clinical trial, children aged 6-59 months were randomized to receive ASAQ or AL. Both drug regimens were given for 3 days, and follow-up was for 28 days. The primary endpoint was the 28-day cure rates and was defined as proportion of patients with polymerase chain reaction (PCR)-corrected cure rate after 28 days of follow-up. Findings: A total of 251 patients who were attending the Ayame and Dabakala hospitals and presenting with symptomatic acute uncomplicated falciparum malaria were randomized to receive ASAQ (128) and AL (123). The intention-to-treat analysis showed effectiveness rates of 94.5% and 93.5% for ASAQ and AL, respectively on day 28. After adjustment for PCR results, these rates were 96.1% and 96.8%, respectively. On day 28, the per-protocol analysis showed effectiveness rates of 98.4% and 96.6% for ASAQ and AL, respectively. After adjustment by PCR for reinfection, these rates were 100% for each drug, and both regimens were well tolerated. Conclusion: ASAQ and AL remain efficacious treatments of uncomplicated falciparum malaria in Ivorian children 5 years after adoption. The efficacy of ASAQ and AL in Côte d'Ivoire requires, therefore, continuous monitoring and evaluation.

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Substandard anti-malarial drugs in Burkina Faso

Cited by 62 publications

References 25 publications

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Recent uptake of intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine is associated with increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso

Assessment of the efficacy of first-line antimalarial drugs after 5 years of deployment by the National Malaria Control Programme in Côte d'Ivoire

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Substandard anti-malarial drugs in Burkina Faso

Cited by 62 publications

References 25 publications

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Quality Control of Selected Antimalarials Sold in the Illicit Market: An Investigation Conducted in Porto-Novo City (Republic of Benin)

Recent uptake of intermittent preventive treatment during pregnancy with sulfadoxine–pyrimethamine is associated with increased prevalence of Pfdhfr mutations in Bobo-Dioulasso, Burkina Faso

Assessment of the efficacy of first-line antimalarial drugs after 5 years of deployment by the National Malaria Control Programme in C&ocirc;te d'Ivoire

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Assessment of the efficacy of first-line antimalarial drugs after 5 years of deployment by the National Malaria Control Programme in Côte d'Ivoire