Molecular epidemiology of malaria in Cameroon. XIX. Quality of antimalarial drugs used for self-medication
Molecular epidemiology of malaria in Cameroon. XIX. Quality of antimalarial drugs used for self-medication
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DOI：
10.4269/ajtmh.2004.70.245
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发表时间：
2004-03-01
影响因子：
3.3
通讯作者：
Basco, LK
中科院分区：
文献类型：
--
作者：
Basco, LK
低于标准和假冒药品越来越多地在世界各地流通和分销，特别是在欠发达国家。这些低质量或假冒产品往往涉及在预防和治疗高度流行疾病方面需求量很大的药物，如疟疾流行国家的抗疟药物。在非洲，用从非官方药品供应商购买的药品自行治疗假定的疟疾感染是一种常见的做法。本研究的目的是调查从喀麦隆城市和农村地区非法部门获得的氯喹，奎宁和磺胺乙胺嘧啶的质量，并分析这些药物对患者的影响。我们从全国16个村庄和城市的132个不同来源收集了三种抗疟药物的284份样本。我们还收集了疟疾感染者用于自我治疗的抗疟药物。通过简单的显色反应试验和半定量薄层色谱法评价药物质量。133种氯喹中有50种（38%），70种奎宁中有52种（74%），81种抗叶酸剂中有10种（12%）没有活性成分，活性成分不足，成分错误或成分未知。用从非官方供应商购买的抗疟药物进行自我治疗，并不是降低发病率和死亡率的可靠战略。这些假药助长了抗药性疟疾寄生虫的传播，并可能导致治疗失败和医疗费用增加。
Substandard and counterfeit pharmaceutical products are increasingly circulating and distributed around the world, in particular in less developed countries. These low-quality or counterfeit products often involve drugs that are in high demand for the prevention and treatment of highly prevalent diseases, such as antimalarial drugs in endemic countries. Self-medication for presumed malarial infections with drugs purchased from unofficial drug vendors is a common practice in Africa. The aim of the study was to investigate the quality of chloroquine, quinine, and sulfadoxine-pyrimethamine obtained from illegitimate sector in urban and rural areas in Cameroon and analyze the impact of these drugs on patients. We collected 284 samples of three antimalarial drugs from 132 different sources in 16 villages and cities throughout the country. We also collected antimalarial drugs that were used for self-medication by malaria-infected patients. Drug quality was assessed by a simple color reaction test and semi-quantitative thin-layer chromatography. Fifty (38%) of 133 chloroquine, 52 (74%) of 70 quinine, and 10 (12%) of 81 antifolates had either no active ingredient, an insufficient active ingredient, the wrong ingredient, or unknown ingredient(s). Self-medication with antimalarial drugs purchased from unofficial vendors is not a reliable strategy to diminish morbidity and mortality. These counterfeit drugs contribute to the spread of drug-resistant malaria parasites and may lead to increasing therapeutic failure and medical expense.