Poor quality vital anti-malarials in Africa - an urgent neglected public health priority
Poor quality vital anti-malarials in Africa - an urgent neglected public health priority
Blog Article
Abstract Background Plasmodium falciparum malaria remains a major public health problem.A vital component of malaria control rests on the availability of good quality artemisinin-derivative based combination therapy (ACT) at the correct dose.However, there are increasing reports of poor quality anti-malarials in Africa.
Methods Seven collections of artemisinin derivative monotherapies, ACT and halofantrine anti-malarials of suspicious quality were collected in 2002/10 in eleven African countries and in Asia en route to Africa.Packaging, chemical composition (high performance liquid chromatography, direct ionization mass spectrometry, X-ray diffractometry, stable isotope analysis) and botanical investigations were performed.Results copyright artesunate containing chloroquine, copyright dihydroartemisinin (DHA) containing paracetamol (acetaminophen), copyright DHA-piperaquine containing sildenafil, copyright strikketøy oppbevaring artemether-lumefantrine containing pyrimethamine, copyright halofantrine containing artemisinin, and substandard/copyright or degraded artesunate and artesunate+amodiaquine in eight countries are described.
Pollen analysis was consistent with manufacture of counterfeits in eastern Asia.These data do not allow estimation of the frequency of poor quality anti-malarials in Africa.Conclusions Criminals are producing diverse harmful anti-malarial counterfeits with important public health consequences.
The presence of artesunate monotherapy, substandard and/or degraded and copyright medicines containing sub-therapeutic amounts of unexpected anti-malarials will engender drug resistance.With the threatening spread of artemisinin resistance to Africa, much greater investment is required to ensure lightemupsequences.com the quality of ACTs and removal of artemisinin monotherapies.The International Health Regulations may need to be invoked to counter these serious public health problems.