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) |