Quality of the antimalarial medicine artemether - lumefantrine in 8 cities of the Democratic Republic of the Congo

Drug Test Anal. 2018 Oct;10(10):1599-1606. doi: 10.1002/dta.2420. Epub 2018 Jul 18.

Abstract

In the context of post-marketing surveillance supporting public-health authorities to take evidence-based decisions to fight the spread of poor-quality medicines, the quality of antimalarial artemether-lumefantrine (AL) medicines was assessed in the Democratic Republic of the Congo (DRC). A total of 150 samples of AL-containing products was collected from private pharmaceutical outlets in 8 main cities: Goma, Kikwit, Kinshasa, Kisangani, Lubumbashi, Matadi, Mbandaka, and Mbuji-Mayi. All drug samples were successively analyzed by visual inspection, thin-layer chromatography (TLC), and high-performance liquid chromatography (HPLC) following The International Pharmacopoeia. Of the 150 collected drug samples, 3 (2%) failed the visual inspection as they had shelf lives different from those of other samples with the same brand name. Four samples (2.7%) did not pass the TLC test as they contained only 1 or even none of the 2 declared active pharmaceutical ingredients (APIs). HPLC assays showed that 46 (30.7%) samples had artemether contents below 90% and 17 (11.3%) above 110% of the content claimed on the label. For lumefantrine, 32 (21.7%) samples had contents below 90%, and 8 (5.3%) had contents above 110%. This survey in DRC gives evidence that poor-quality antimalarial medicines are widely present. Based on 3 detection techniques, the study shows the necessity to equip developing countries with modern techniques such as HPLC, which, if combined with affordable techniques like TLC, could provide a pertinent analytical strategy to combat drug counterfeiting and poor manufacturing.

Keywords: Antimalarial drugs; HPLC; TLC; poor-quality medicines; visual inspection.

MeSH terms

  • Antimalarials / chemistry*
  • Antimalarials / therapeutic use
  • Artemether / chemistry*
  • Artemether / therapeutic use
  • Chromatography, High Pressure Liquid / methods*
  • Chromatography, Thin Layer / methods*
  • Congo / epidemiology
  • Drug Contamination
  • Drug Stability
  • Humans
  • Lumefantrine / chemistry*
  • Lumefantrine / therapeutic use
  • Malaria / drug therapy
  • Malaria / epidemiology
  • Quality Control*

Substances

  • Antimalarials
  • Artemether
  • Lumefantrine