Poor quality vital anti-malarials in Africa - an urgent neglected public health priority
| Autor: | Henry Nettey, Paul N. Newton, Stephen K Opuni, Serge Barbereau, Peter M Fernandes, Michael D. Green, Leonard Nyadong, Kevin Faure, Dana M. Hostetler, Kristen Powell, Isabel Swamidoss, Jonarthan Thevanayagam, Facundo M. Fernández, Brian Angus, Aline Plançon, Glenn A. Harris, Ray C W Soong, Abdinasir A Amin, Dallas C. Mildenhall, Ans Timmermans, Claude Faurant, Kasia Stepniewska, Harparkash Kaur, Philippe J Guerin |
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| Jazyk: | angličtina |
| Předmět: |
lcsh:Arctic medicine. Tropical medicine
Asia lcsh:RC955-962 medicine.medical_treatment 030231 tropical medicine Dihydroartemisinin Amodiaquine Chemistry Techniques Analytical lcsh:Infectious and parasitic diseases 03 medical and health sciences chemistry.chemical_compound Antimalarials Lactones 0302 clinical medicine Halofantrine parasitic diseases Medicine Humans lcsh:RC109-216 030212 general & internal medicine Artemisinin Drug Packaging Quality of Health Care Traditional medicine business.industry Research medicine.disease Artemisinins 3. Good health Counterfeit Infectious Diseases chemistry Artesunate Counterfeit Drugs Africa Parasitology business Malaria medicine.drug |
| Zdroj: | Malaria Journal Malaria Journal, Vol 10, Iss 1, p 352 (2011) |
| ISSN: | 1475-2875 |
| DOI: | 10.1186/1475-2875-10-352 |
| Popis: | 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 Counterfeit artesunate containing chloroquine, counterfeit dihydroartemisinin (DHA) containing paracetamol (acetaminophen), counterfeit DHA-piperaquine containing sildenafil, counterfeit artemether-lumefantrine containing pyrimethamine, counterfeit halofantrine containing artemisinin, and substandard/counterfeit 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 counterfeit 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 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. |
| Databáze: | OpenAIRE |
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