PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study in Nigeria finds 1 in 10 malaria drugs are poor quality

Substandard medicines more prevalent than fakes in world's most malaria-burdened country

2015-05-27
(Press-News.org) A rigorous analysis of more than 3,000 antimalarials purchased in Enugu, Nigeria found 9.3% to be of poor quality, according to new research published in PLOS ONE.

Researchers found 1.2% of the samples to be falsified and 1.3% to be degraded, but raised bigger concerns about 6.8% being of substandard manufacture, leaving patients at risk of not receiving the correct treatment dose and potentially contributing to the development of resistance to the main drug used to treat malaria.

The drug quality team of the Artemisinin-based Combination Therapy (ACT) Consortium at the London School of Hygiene & Tropical Medicine analysed 3,024 antimalarials containing artemisinin (the component that makes malaria treatment effective) from Enugu Metropolis, South East Nigeria, which has a population of 3.3 million. Nigeria is the single most heavily malaria-burdened country in the world, with 48 million malaria cases and 180,000 deaths per year.

Dr Harparkash Kaur, from the London School of Hygiene & Tropical Medicine, lead investigator of the drug quality programme of the ACT Consortium, said: "Although these results raise concerns, they are reassuring in comparison with previous reports that found that more than 35% of antimalarials in sub-Saharan Africa failed chemical content analysis - in other words, were poor quality. This may be because those reports predominantly used a "convenience" approach to select samples for analysis, which may not be representative of the places where patients buy their medicines."

The team purchased medicines from 421 outlets in Enugu including pharmacies, patent medicine vendors, and public health facilities. In addition to "convenience" sampling, which lacks systematic guidance on which outlets to sample from, samples were also bought from a representative sample of outlets. Two approaches were used in the representative sampling: a covert approach, using "mystery clients" in which researchers pretended to be patients with malaria, or their relatives, asking to buy medicines; and an "overt" approach, where researchers told vendors openly that they were going to analyse the quality of their malaria medicines.

Each sample was analysed in three independent laboratories in the UK and USA and classified as acceptable quality, falsified (fake drugs which do not contain the stated active pharmaceutical ingredient or API), substandard (which contain inadequate amounts of the active ingredients), or degraded (decomposition of the API by poor storage conditions, such as heat and humidity).

All three sampling methods detected falsified drugs, but the prevalence was higher in samples purchased using the convenience approach.

Falsified samples contained chemicals other than the stated API, such as chlorzoxazone (a muscle relaxant), ciprofloxacin (an antibiotic) or acetaminophen (a commonly used painkiller).

The team also identified artemisinin-based monotherapy tablets, which are no longer recommended by the World Health Organization because they do not include the partner compound that makes it an effective artemisinin-based combination therapy. Some of these monotherapies were also falsified.

Substandard or degraded drugs were more prevalent than falsified ones in Enugu. Poor quality drugs were frequently found in patent medicine vendors - also known as drug shops, which are the main source of treatment for most patients - rather than in pharmacies.

Study co-author Prof. Obinna Onwujekwe from the University of Nigeria, Enugu said: "The results show that the health system actors should be eternally vigilant in Nigeria and in other countries to ensure that sub-standard drugs do not impede or erode gains made in malaria treatment. Drug regulatory authorities and their partners should intensify drug quality monitoring activities with appropriate sanctions for defaulters."

The ACT Consortium's large drug quality programme, which has analysed over 10,000 samples from six malaria endemic countries over five years, has recently published results from Tanzania and Cambodia, where substandard medicines were of similar concern but where no falsified medicines were found. Results from Equatorial Guinea, Ghana and Rwanda will be published in the next few months.

INFORMATION:

The ACT Consortium is funded by a grant from the Bill & Melinda Gates Foundation to London School of Hygiene & Tropical Medicine.

For more information or to request interviews contact the press office at the London School of Hygiene & Tropical Medicine: press@lshtm.ac.uk and +44 (0)20 7927 2802.

Notes to Editors:

* Harparkash Kaur, Elizabeth Louise Allan, Ibrahim Mamadu, Zoe Hall, Ogochukwu Ibe, Mohamed El Sherbiny, Albert van Wyk, Shunmay Yeung, Siân Clarke, Isabel Swamidoss, Michael D Green, Prabha Dwivedi, Maria Julia Culzoni, David Schellenberg, Obinna Onwujekwe. Quality of Artemisinin-Based Combination Formulations for Malaria Treatment: Prevalence and risk factors for poor quality medicines in public facilities and private sector drug outlets in Enugu, Nigeria. PLOS ONE. DOI: 10.1371/journal.pone.0125577

Falsified drugs carry false representations of their source or identity, and often contain none of the stated active ingredient(s). Counterfeit medicines are medicines that do not comply with intellectual property rights or that infringe trademark law.

Researchers used the analytical technique of high performance liquid chromatography (HPLC) for the quantitative analysis and mass spectrometry for the qualitative analysis. USP and WHO pharmacopeia rules define drugs as being poor quality if they contain less than 90% or more than 110% of the stated amount of the API. The ACT Consortium adopted the slightly less stringent range of 85% to 115% API as acceptable. Results are sensitive to these limits.

Collaborating institutions: Enugu State Ministry of Health, Nigeria, University of Nigeria, US Centers for Disease Control and Prevention, USA, Georgia Institute of Technology, USA.

About the ACT Consortium The ACT Consortium is an international research collaboration working on 25 projects in 10 countries to answer key questions on malaria drug delivery. Since initiating activities in 2008, the Consortium has been working to optimise the use of Artemisinin-based Combination Therapy (ACT), the first-line treatment for the most dangerous form of malaria recommended by the World Health Organization. The projects investigate ways to improve the access and targeting of ACTs, as well as assessing their safety and quality. The ACT Consortium is based at the London School of Hygiene & Tropical Medicine and a member of the School's Malaria Centre. Learn more about the drug quality programme at http://www.actconsortium.org/drugquality and watch a video at https://vimeo.com/125049233. The ACT Consortium will host a drug quality event on 28 May 2015 in Geneva, Switzerland. Find out more information on the above website.

About the London School of Hygiene & Tropical Medicine The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with 3,900 students and more than 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, and was recently cited as the world's leading research-focused graduate school. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www.lshtm.ac.uk



ELSE PRESS RELEASES FROM THIS DATE:

Pitt's Arthur S. Levine, M.D., and 17 other med school deans speak out

2015-05-27
PITTSBURGH, May 27, 2015 - Cuts in federal support and unreliable funding streams are creating a hostile work environment for scientists, jeopardizing the future of research efforts and ultimately clinical medicine, according to leaders of the nation's top academic medical centers in today's online issue of Science Translational Medicine. Led by Arthur S. Levine, M.D., the University of Pittsburgh senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of Medicine, medical school deans from 18 institutions reviewed the financial challenges ...

Diagnosing cancer with help from bacteria

2015-05-27
CAMBRIDGE, MA -- Engineers at MIT and the University of California at San Diego (UCSD) have devised a new way to detect cancer that has spread to the liver, by enlisting help from probiotics -- beneficial bacteria similar to those found in yogurt. Many types of cancer, including colon and pancreatic, tend to metastasize to the liver. The earlier doctors can find these tumors, the more likely that they can successfully treat them. "There are interventions, like local surgery or local ablation, that physicians can perform if the spread of disease in the liver is confined, ...

Job-sharing with nursing robot

Job-sharing with nursing robot
2015-05-27
Given the aging of the population and the low birthrate both in Japan and elsewhere, healthcare professionals are in short supply and unevenly distributed, giving rise to a need for alternatives to humans for performing simple tasks. Although increasing numbers of medical institutions have introduced electronic medical records, a variety of issues remain unresolved, such as the inconvenience of data recording and the high costs associated with data input. The use of robots to support medical care data management and the delivery of resources at the medical front--thus ...

Machine-learning breakthrough paves way for medical screening, prevention and treatment

2015-05-27
A breakthrough in machine learning has also brought about a "game changer" for the science of metabolomics - and will hasten the development of diagnostic and predictive tests for Alzheimer's, cancer, diabetes and numerous other conditions, leading to improved prevention and treatment. University of Alberta computing science PhD graduate Siamak Ravanbakhsh published his research in the scientific journal PLOS ONE on an automated process that increases the speed and accuracy of producing a person's metabolic profile from a sample of biofluid such as blood serum or cerebrospinal ...

Starting antiretroviral treatment early improves outcomes for HIV-infected individuals

2015-05-27
A major international randomized clinical trial has found that HIV-infected individuals have a considerably lower risk of developing AIDS or other serious illnesses if they start taking antiretroviral drugs sooner, when their CD4+ T-cell count--a key measure of immune system health--is higher, instead of waiting until the CD4+ cell count drops to lower levels. Together with data from previous studies showing that antiretroviral treatment reduced the risk of HIV transmission to uninfected sexual partners, these findings support offering treatment to everyone with HIV. The ...

Biggest research threat at academic medical centers: Reduced funding and clinical revenue

2015-05-27
(Boston)--Reductions in federal support and clinical revenue not only jeopardize biomedical research at academic medical centers, but may ultimately impact clinical medicine according to an opinion piece in the journal Science Translational Medicine. Biomedical research is crucial to the US national agenda and academic medical centers--the provenance for much of this research - are at particular risk, according to the authors. Persistent constraints on federal funding threaten to undermine this, and decreasing clinical revenue due to increasingly constrained reimbursement ...

Microbes collected by citizen scientists and grown on the International Space Station

2015-05-27
(SACRAMENTO, Calif.) -- Do microbes grow differently on the International Space Station than they do on Earth? Results from the growth of microbes collected by citizen scientists in Project MERCCURI indicate that most behave similarly in both places. "While this data is extremely preliminary, it is potentially encouraging for long-term manned spaceflight," said David Coil, Ppoject scientist in the microbiology lab of Jonathan Eisen at the University of California, Davis. "With this part of Project MERCCURI we hoped to shed light on how microbes associated with the normal, ...

This week from AGU: NASA Earth science, Climate change music, Tibetan Plateau evolution

2015-05-27
From AGU's blogs: Should NASA be Studying the Earth? Joseph R. Dwyer, a Professor at the Department of Physics and the Space Science Center in the Institute for the Study of Earth, Oceans, and Space at the University of New Hampshire, shares his thoughts about whether NASA should be studying the Earth in a blog post on The Bridge. From Eos.org: Musical Composition Conveys Climate Change Data A student at the University of Minnesota communicates climate change science in an innovative way. From AGU's journals: Dynamics of the Earth's Surface in the Eastern Tibetan ...

Hubble sees shock collision inside black hole jet

Hubble sees shock collision inside black hole jet
2015-05-27
When you're blasting though space at more than 98 percent of the speed of light, you may need driver's insurance. Astronomers have discovered for the first time a rear-end collision between two high-speed knots of ejected matter. This discovery was made while piecing together a time-lapse movie of a plasma jet blasted from a supermassive black hole inside a galaxy located 260 million light-years from earth. The finding offers new insights into the behavior of "light saber-like" jets that are so energized that they appear to zoom out of black hole at speeds several times ...

New human ancestor species from Ethiopia lived alongside Lucy's species

2015-05-27
Cleveland . . . A new relative joins "Lucy" on the human family tree. An international team of scientists, led by Dr. Yohannes Haile-Selassie of The Cleveland Museum of Natural History, has discovered a 3.3 to 3.5 million-year-old new human ancestor species. Upper and lower jaw fossils recovered from the Woranso-Mille area of the Afar region of Ethiopia have been assigned to the new species Australopithecus deyiremeda. This hominin lived alongside the famous "Lucy's" species, Australopithecus afarensis. The species will be described in the May 28, 2015 issue of the international ...

LAST 30 PRESS RELEASES:

Storing electrons from hydrogen for clean chemical reactions

Unlocking how to use mRNA to target Alzheimer’s disease

Kessler Foundation secures $770,000 in grants to advance leading-edge spinal cord research

Going ‘back to the future’ to forecast the fate of a dead Florida coral reef

How extratropical ocean-atmosphere interactions can contribute to the variability of jet streams in the Northern Hemisphere

MSK Research Highlights, March 28, 2024

USDA, Nueta Hidatsa Sahnish College collaborate to support Indigenous Seed Sovereignty

For younger women, mental health now may predict heart health later

Missed opportunity: AEDs near cardiac arrests rarely used by bystanders

Eggs may not be bad for your heart after all

Alcohol raises heart disease risk, particularly among women

TTUHSC announces new center for nursing research

Adding just enough fuel to the fire

Impact of synbiotic supplements on the gut microbiome and overall health of penguins

Promising advances in organosilica membranes for separating organic liquid mixtures

Cell phone video technology unveils new method for analyzing walking and gait

Ancient isolation’s impact on modern ecology

Synaptic protein change during development offers clues on evolution and disease

How commercial rooftop solar power could bring affordable clean energy to low-income homes

Taking a closer look at pulmonary fibrosis genetics

Cats with MDR1 mutation at risk of severe reactions to popular medication

IOP Publishing and IPEM mandate reporting of sex and gender in research 

Dogs trained to detect trauma stress by smelling humans’ breath

Electronic device thermal management made simpler and slightly better!

Study: Dangerous surgical site infections can be reduced with simple prevention protocol

Genetic testing of patients with atrial fibrillation can alert clinicians to potential development of life-threatening conditions

Artificial Intelligence tool successfully predicts fatal heart rhythm

What progress has China made in agriculture green development over the past five years?

ALMA finds new molecular signposts in starburst galaxy

Open waste burning linked to air pollution in Northwestern Greenland

[Press-News.org] Study in Nigeria finds 1 in 10 malaria drugs are poor quality
Substandard medicines more prevalent than fakes in world's most malaria-burdened country