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Table 1 Summary of selected recently published surveys of anti-malarial medicines quality in Africa and Southeast Asia

From: Combating poor-quality anti-malarial medicines: a call to action

Region/country and year Product and number of samples Source(s) and sampling Key results
Africa
 Tanzania
 2010
 [24]
Artemisinin-containing
N = 1737
Source: private retail outlets
Sampling: nationally representative sample
All samples contained an API
Artemisinin-containing derivative:
4.1 % substandard (outside the 85–115 % API range)
PQ drugs had 10 % of the odds of being poor-quality vs non-PQ
Partner drugs
12.1 % substandard
PQ had 4 % of the odds of being poor-quality
 Ghana, Togo
 2010–2011
 [28]
Artemisinin-containing
N = 132
Source: retail outlet
Sampling: convenience sample
Only one sample lacked an API
Combination products: 83.7 % (outside 90–110 % API)
Monotherapy: 57.9 % substandard
 Nigeria
 2012–2013
 [23]
Artemisinin-containing
N = 3024
Sources: pharmacies (35.6 %), patent medicine vendors (60.6 %), public health facilities (3.6 %), market stalls (0.2 %)
Sampling: mostly mystery client (63.5 %), then overt (6.6 %) or convenience (29.9 %)
9.2 % poor-quality: 6.8 % substandard; 1.3 % degraded; 1.2 % falsified
Convenience sampling yielded a significantly higher prevalence of poor-quality
 Democratic Republic of Congo
 2014
 [25]
Artemisinin-containing
N = 238a
Source: private licenced wholesalers
Sampling: cross-sectional, mystery client
21 % were found non-conform for the content in API
48 % were under-dosed in artemether
Southeast Asia
 Cambodia
 2010–2011
 [30]
Artemisinin derivatives
N = 291
Sources: private health provider
Sampling: mystery client
All samples contained an API
Overall: 31.3 % substandard (outside range of 85 % and < 115 %)
24.7 % were expired
Artesunate tablets: 25.8 % (60/233) substandard
Co-blistered mefloquine: 73.4 % (149/203) substandard
Considering both drugs: 77.3 % (157/203) substandard
 Lao People’s Democratic Republic (Laos)
 2012
 [31]
Various anti-malarial medicines
N = 146
Source: Private retail outlets
Sampling: Cross-sectional random sample, mystery client
All samples contained an API
25.4 % substandard (outside 90–110 % API)
  1. aSamples included amoxicillin, artemether/lumefantrine powder for suspension in paediatric dosage and paracetamol tablets 500 mg