Quality of antimalarials at the epicenter of antimalarial drug resistance: results from an overt and mystery client survey in Cambodia

Am J Trop Med Hyg. 2015 Jun;92(6 Suppl):39-50. doi: 10.4269/ajtmh.14-0391. Epub 2015 Apr 20.

Abstract

Widespread availability of monotherapies and falsified antimalarials is thought to have contributed to the historical development of multidrug-resistant malaria in Cambodia. This study aimed to document the quality of artemisinin-containing antimalarials (ACAs) and to compare two methods of collecting antimalarials from drug outlets: through open surveyors and mystery clients (MCs). Few oral artemisinin-based monotherapies and no suspected falsified medicines were found. All 291 samples contained the stated active pharmaceutical ingredient (API) of which 69% were considered good quality by chemical analysis. Overall, medicine quality did not differ by collection method, although open surveyors were less likely to obtain oral artemisinin-based monotherapies than MCs. The results are an encouraging indication of the positive impact of the country's efforts to tackle falsified antimalarials and artemisinin-based monotherapies. However, poor-quality medicines remain an ongoing challenge that demands sustained political will and investment of human and financial resources.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / chemistry*
  • Antimalarials / economics
  • Antimalarials / standards
  • Cambodia / epidemiology
  • Commerce
  • Data Collection
  • Drug Labeling
  • Drug Packaging
  • Drug Resistance
  • Humans
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / epidemiology
  • Malaria, Falciparum / parasitology
  • Pharmacies
  • Plasmodium falciparum / drug effects*
  • Quality Control
  • Risk Factors

Substances

  • Antimalarials