Cargando…
The quality of anti-malarial medicines in Embu County, Kenya
BACKGROUND: Malaria is a major health problem in sub-Saharan Africa where over 90% of the world’s malaria cases occur. Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization as first-line and second-line treatments for uncomplicated falciparum malaria. However, t...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138895/ https://www.ncbi.nlm.nih.gov/pubmed/30219080 http://dx.doi.org/10.1186/s12936-018-2482-3 |
_version_ | 1783355421064429568 |
---|---|
author | Ndwigah, Stanley Stergachis, Andy Abuga, Kennedy Mugo, Hannington Kibwage, Isaac |
author_facet | Ndwigah, Stanley Stergachis, Andy Abuga, Kennedy Mugo, Hannington Kibwage, Isaac |
author_sort | Ndwigah, Stanley |
collection | PubMed |
description | BACKGROUND: Malaria is a major health problem in sub-Saharan Africa where over 90% of the world’s malaria cases occur. Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization as first-line and second-line treatments for uncomplicated falciparum malaria. However, there are a growing number of reports of sub-standard and falsified anti-malarial medicines in sub-Saharan Africa. METHODS: A cross-sectional study was conducted in Embu County, Kenya on the quality of anti-malarial medicines available in public and private facilities. Sampling of anti-malarial medicines from public and private hospitals, health centers and pharmacies was conducted between May and June 2014. Quality control tests were performed at the Drug Analysis and Research Unit, University of Nairobi, using ultraviolet spectrophotometry and high-performance liquid chromatography. A test for microbial load was also conducted for suspension formulations. RESULTS: A total of 39 samples were collected from public and private facilities across the Embu County. A visual inspection of the medicines showed no signs of sub-standard or falsification. All ACT passed identification, assay and dissolution tests. Of 11 suspension samples collected, none failed the microbial load test although one sample had 50 colony forming units (cfu). No oral artemisinin monotherapy medicines were encountered during the survey. Amodiaquine and chloroquine monotherapy products accounted for 5% of the collected samples, despite their ban in Kenya. Two herbal anti-malarial formulations were collected during the survey. Sulfadoxine/pyrimethamine (SP) was also found to be available use for malaria treatment, not in accordance with malaria treatment guidelines. CONCLUSION: All the anti-malarial drugs analysed in this study passed the quality control tests. This is encouraging given the high malaria burden in Kenya. Regulatory actions are required to counter SP and herbal products for malaria treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-018-2482-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6138895 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-61388952018-09-15 The quality of anti-malarial medicines in Embu County, Kenya Ndwigah, Stanley Stergachis, Andy Abuga, Kennedy Mugo, Hannington Kibwage, Isaac Malar J Research BACKGROUND: Malaria is a major health problem in sub-Saharan Africa where over 90% of the world’s malaria cases occur. Artemisinin-based combination therapy (ACT) is recommended by the World Health Organization as first-line and second-line treatments for uncomplicated falciparum malaria. However, there are a growing number of reports of sub-standard and falsified anti-malarial medicines in sub-Saharan Africa. METHODS: A cross-sectional study was conducted in Embu County, Kenya on the quality of anti-malarial medicines available in public and private facilities. Sampling of anti-malarial medicines from public and private hospitals, health centers and pharmacies was conducted between May and June 2014. Quality control tests were performed at the Drug Analysis and Research Unit, University of Nairobi, using ultraviolet spectrophotometry and high-performance liquid chromatography. A test for microbial load was also conducted for suspension formulations. RESULTS: A total of 39 samples were collected from public and private facilities across the Embu County. A visual inspection of the medicines showed no signs of sub-standard or falsification. All ACT passed identification, assay and dissolution tests. Of 11 suspension samples collected, none failed the microbial load test although one sample had 50 colony forming units (cfu). No oral artemisinin monotherapy medicines were encountered during the survey. Amodiaquine and chloroquine monotherapy products accounted for 5% of the collected samples, despite their ban in Kenya. Two herbal anti-malarial formulations were collected during the survey. Sulfadoxine/pyrimethamine (SP) was also found to be available use for malaria treatment, not in accordance with malaria treatment guidelines. CONCLUSION: All the anti-malarial drugs analysed in this study passed the quality control tests. This is encouraging given the high malaria burden in Kenya. Regulatory actions are required to counter SP and herbal products for malaria treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12936-018-2482-3) contains supplementary material, which is available to authorized users. BioMed Central 2018-09-15 /pmc/articles/PMC6138895/ /pubmed/30219080 http://dx.doi.org/10.1186/s12936-018-2482-3 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Ndwigah, Stanley Stergachis, Andy Abuga, Kennedy Mugo, Hannington Kibwage, Isaac The quality of anti-malarial medicines in Embu County, Kenya |
title | The quality of anti-malarial medicines in Embu County, Kenya |
title_full | The quality of anti-malarial medicines in Embu County, Kenya |
title_fullStr | The quality of anti-malarial medicines in Embu County, Kenya |
title_full_unstemmed | The quality of anti-malarial medicines in Embu County, Kenya |
title_short | The quality of anti-malarial medicines in Embu County, Kenya |
title_sort | quality of anti-malarial medicines in embu county, kenya |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138895/ https://www.ncbi.nlm.nih.gov/pubmed/30219080 http://dx.doi.org/10.1186/s12936-018-2482-3 |
work_keys_str_mv | AT ndwigahstanley thequalityofantimalarialmedicinesinembucountykenya AT stergachisandy thequalityofantimalarialmedicinesinembucountykenya AT abugakennedy thequalityofantimalarialmedicinesinembucountykenya AT mugohannington thequalityofantimalarialmedicinesinembucountykenya AT kibwageisaac thequalityofantimalarialmedicinesinembucountykenya AT ndwigahstanley qualityofantimalarialmedicinesinembucountykenya AT stergachisandy qualityofantimalarialmedicinesinembucountykenya AT abugakennedy qualityofantimalarialmedicinesinembucountykenya AT mugohannington qualityofantimalarialmedicinesinembucountykenya AT kibwageisaac qualityofantimalarialmedicinesinembucountykenya |