Suspected poor-quality medicines in Kenya: a retrospective descriptive study of medicine quality-related complaints reports in Kenya's pharmacovigilance database.

Autor: Toroitich AM; Pharmacy and Poisons Board, P.O. Box 27663 - 00506, Nairobi, Kenya.; Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, LE1 9BH, UK., Armitage R; Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, LE1 9BH, UK.; School of Archaeology and Ancient History, University of Leicester, University Road, Leicester, LE1 7RH, UK., Tanna S; Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester, LE1 9BH, UK. stanna@dmu.ac.uk.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Sep 19; Vol. 24 (1), pp. 2561. Date of Electronic Publication: 2024 Sep 19.
DOI: 10.1186/s12889-024-20036-4
Abstrakt: Poor-quality, substandard and falsified, medicines pose a significant public health threat, particularly in low-middle-income countries. A retrospective study was performed on Kenya's Pharmacovigilance Electronic Reporting System (2014-2021) to characterize medicine quality-related complaints and identify associations using disproportionality analysis. A total of 2767 individual case safety reports were identified, categorized into medicines with quality defects (52.1%), suspected therapeutic failure (41.6%), and suspected adverse drug reactions (6.3%). Predominantly reported were antineoplastic agents (28.6%), antivirals (11.7%), and antibacterial agents (10.8%) potentially linked to non-adherence to good manufacturing practices, inappropriate usage and supply chain degradation. Notably, analgesics (8.2%), and medical devices (3.5%) notified had quality defects, predominantly from government health facilities (60.0%). Antineoplastic agents (20.2%) and antivirals (3.7%) were frequently reported from suspected therapeutic failures and suspected adverse drug reactions, respectively, across both private for-profit facilities (26.5%) and not-for-profit facilities (5.4%). Underreporting occurred in unlicensed health facilities (8.1%), due to unawareness and reporting challenges. Pharmacists (46.1%), and pharmaceutical technicians (11.7%) predominantly reported quality defects, while medical doctors (28.0%) reported suspected therapeutic failures. Orally administered generic medicines (76.9%) were commonly reported, with tablets (5.8%) identified as potential sources of suspected adverse drug reactions, while quality defects were notified from oral solutions, suspensions, and syrups (7.0%) and medical devices (3.9%). The COVID-19 pandemic correlated with reduced reporting possibly due to prioritization of health surveillance. This study provides valuable evidence to supporting the use of medicine quality-related complaints for proactive, targeted regulatory control of high-risk medicines on the market. This approach can be strengthened by employing standardized terminology to prioritize monitoring of commonly reported suspected poor-quality medicines for risk-based sampling and testing within the supply chain.
(© 2024. The Author(s).)
Databáze: MEDLINE
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