scholarly journals Pharmaceutical quality of antimalarial drugs: quinine sulfate and Artemether/Lumefantrine tablets sold on Bukavu Market

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Aladin Ombeni Mahano ◽  
Aline Zawadi Mahano ◽  
Nelson Hendwa Cubaka ◽  
Félicien Mushagalusa Kasali ◽  
Benjamin Bavurhe Zirirane ◽  
...  

Abstract Background Generic antimalarial drugs sold in sub-Saharan Africa require tighter control as counterfeiting has grown more and more out of control. The study aimed to analyze the pharmaceutical quality of quinine sulfate (QS) and Artemether/Lumefantrine(AL) tablets marketed in Bukavu city compared to the current trends in other African cities. Results The samples were purchased in community pharmacies or from ambulatory street vendors and analyzed using a set of thirteen simple tests, including visual inspection, UV spectrometry, TLC, and conventional quality control procedures. More than 93% of AL samples had an acceptable global quality score of > 90%. Around 16.6% of QS batches did not satisfy the requirements about hardness, friability, and mass uniformity. Only 33.3% met the disintegration quality; 33.3% did not contain quinine; 8.33% had an active ingredient other than quinine. Conclusion The findings strongly alert the circulation of fake antimalarial medicines observed in many countries. Simple TLC procedures may help to detect any low-quality generics to avoid microbial resistance and guarantee the health of the population. Pharmacists and regulatory authorities are alerted to the circulation of low-quality generic quinine preparations in the country.

2021 ◽  
Author(s):  
Aladin Ombeni Mahano ◽  
Aline Zawadi Mahano ◽  
Nelson Hendwa Cubaka ◽  
Félicien Mushagalusa Kasali ◽  
Benjamin Bavurhe Zirirane ◽  
...  

Abstract Background: Malaria is a tropical parasitic disease caused by Plasmodium species, mainly falciparum, transmitted by the female Anopheles mosquito, strongly affecting sub-Saharan Africa and Indian areas. Generic antimalarial drugs sold in these regions require tighter quality control as counterfeiting has grown more and more out of control. The study aimed to analyze the pharmaceutical quality of Quinine sulfate and Artemether/Lumefantrine tablets marketed in Bukavu city compared to current trends in other African cities. Methods: We set up 13 simple TLC and UV spectrometric quality-control tests and applied them to analyze five Quinine brands divided into 12 batches and two Artemether/Lumefantrine brands divided into 12 batches. Quality scores were expressed as a percentage of compliance with each or the whole set of 13 tests. The samples were collected from community pharmacies and ambulatory street vendors. For comparison, available literature data related to the subject was retrieved from Google Scholar and PubMed search. Results: The analysis showed 16.6% of QS batches failed quality specifications concerning hardness, friability, and uniformity of mass; 66.6% failed the disintegration test; 33.3% did not contain quinine, and 8.33% had an active ingredient other than quinine. Only 3 batches exhibited a global score >90%. For Artemether/Lumefantrine, 93% of batches had an acceptable quality score >90%. Conclusion: The findings strongly support literature data from many countries. Simple TLC procedures may help to detect any low-quality generics to avoid microbial resistance and guarantee the health of the population. Pharmacists and regulatory authorities are alerted to the circulation of low-quality generic quinine preparations in the country.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Ansu-Mensah ◽  
Frederick Inkum Danquah ◽  
Vitalis Bawontuo ◽  
Peter Ansu-Mensah ◽  
Tahiru Mohammed ◽  
...  

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.


2017 ◽  
Vol 31 (1) ◽  
pp. 109-138 ◽  
Author(s):  
Mark J. Siedner

Objective: The number of people living with HIV (PLWH) over 50 years old in sub-Saharan Africa is predicted to triple in the coming decades, to 6-10 million. Yet, there is a paucity of data on the determinants of health and quality of life for older PLWH in the region. Methods: A review was undertaken to describe the impact of HIV infection on aging for PLWH in sub-Saharan Africa. Results: We (a) summarize the pathophysiology and epidemiology of aging with HIV in resource-rich settings, and (b) describe how these relationships might differ in sub-Saharan Africa, (c) propose a conceptual framework to describe determinants of quality of life for older PLWH, and (d) suggest priority research areas needed to ensure long-term gains in quality of life for PLWH in the region. Conclusions: Differences in traditional, lifestyle, and envirnomental risk factors, as well as unique features of HIV epidemiology and care delivery appear to substantially alter the contribution of HIV to aging in sub-Saharan Africa. Meanwhile, unique preferences and conceptualizations of quality of life will require novel measurement and intervention tools. An expanded research and public health infrastructure is needed to ensure that gains made in HIV prevention and treamtent are translated into long-term benefits in this region.


2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.


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