Quality testing of artemisinin-based antimalarial drugs in Myanmar

Suqin Guo, Myat Phone Kyaw, Lishan He, Myo Min, Xiangxue Ning, Wei Zhang, Baomin Wang, Liwang Cui

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Artemisinin-based combination therapies are the frontline treatment of Plasmodium falciparum malaria. The circulation of falsified and substandard artemisinin-based antimalarials in Southeast Asia has been a major predicament for the malaria elimination campaign. To provide an update of this situation, we purchased 153 artemisinin-containing antimalarials, as convenience samples, in private drug stores from different regions of Myanmar. The quality of these drugs in terms of their artemisinin derivative content was tested using specific dipsticks for these artemisinin derivatives, as point-of-care devices. A subset of these samples was further tested by high-performance liquid chromatography (HPLC). This survey identified that > 35% of the collected drugs were oral artesunate and artemether monotherapies. When tested with the dipsticks, all but one sample passed the assays, indicating that the detected artemisinin derivative content corresponded approximately to the labeled contents. However, one artesunate injection sample was found to contain no active ingredient at all by the dipstick assay and subsequent HPLC analysis. The continued circulation of oral monotherapies and the description, for the first time, of falsified parenteral artesunate provides a worrisome picture of the antimalarial drug quality in Myanmar during the malaria elimination phase, a situation that deserves more oversight from regulatory authorities.

Original languageEnglish (US)
Pages (from-to)1198-1203
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume97
Issue number4
DOIs
StatePublished - 2017

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Virology
  • Infectious Diseases

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