SETTING: Pharmacies in 19 cities in Angola, Brazil, China, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, India (n = 3), Kenya, Nigeria, Russia, Rwanda, Thailand, Turkey, Uganda, United Republic of Tanzania and Zambia. OBJECTIVE: To assess the quality of the two main first-line anti-tuberculosis medicines, isoniazid and rifampicin, procured from private-sector pharmacies, to determine if substandard and falsified medicines are available and if they potentially contribute to drug resistance in cities in low- and middle-income countries. DESIGN: Local nationals procured 713 treatment packs from a selection of pharmacies in 19 cities. These samples were tested for quality using 1) thin-layer chromatography to analyze levels of active pharmaceutical ingredient (API), and 2) disintegration testing. RESULTS: Of 713 samples tested, 9.1% failed basic quality testing for requisite levels of API or disintegration. The failure rate was 16.6% in Africa, 10.1% in India, and 3.9% in other middle-income countries. CONCLUSIONS: Substandard and falsified drugs are readily available in the private marketplace and probably contribute to anti-tuberculosis drug resistance in low- and middle-income countries. This issue warrants further investigation through large-scale studies of drug quality in all markets.
SETTING: Pharmacies in 19 cities in Angola, Brazil, China, Democratic Republic of Congo, Egypt, Ethiopia, Ghana, India (n = 3), Kenya, Nigeria, Russia, Rwanda, Thailand, Turkey, Uganda, United Republic of Tanzania and Zambia. OBJECTIVE: To assess the quality of the two main first-line anti-tuberculosis medicines, isoniazid and rifampicin, procured from private-sector pharmacies, to determine if substandard and falsified medicines are available and if they potentially contribute to drug resistance in cities in low- and middle-income countries. DESIGN: Local nationals procured 713 treatment packs from a selection of pharmacies in 19 cities. These samples were tested for quality using 1) thin-layer chromatography to analyze levels of active pharmaceutical ingredient (API), and 2) disintegration testing. RESULTS: Of 713 samples tested, 9.1% failed basic quality testing for requisite levels of API or disintegration. The failure rate was 16.6% in Africa, 10.1% in India, and 3.9% in other middle-income countries. CONCLUSIONS: Substandard and falsified drugs are readily available in the private marketplace and probably contribute to anti-tuberculosis drug resistance in low- and middle-income countries. This issue warrants further investigation through large-scale studies of drug quality in all markets.
Authors: D Nabirova; G Schmid; R Yusupova; M Kantarbayeva; S I Ismailov; D Moffett; R W O Jähnke; J P Nuorti Journal: Int J Tuberc Lung Dis Date: 2017-10-01 Impact factor: 2.373
Authors: H McIlleron; H Hundt; W Smythe; A Bekker; J Winckler; L van der Laan; P Smith; H J Zar; A C Hesseling; G Maartens; L Wiesner; A van Rie Journal: Int J Tuberc Lung Dis Date: 2016-07 Impact factor: 2.373
Authors: Mustapha Hajjou; Laura Krech; Christi Lane-Barlow; Lukas Roth; Victor S Pribluda; Souly Phanouvong; Latifa El-Hadri; Lawrence Evans; Christopher Raymond; Elaine Yuan; Lang Siv; Tuan-Anh Vuong; Kwasi Poku Boateng; Regina Okafor; Kennedy M Chibwe; Patrick H Lukulay Journal: Am J Trop Med Hyg Date: 2015-04-20 Impact factor: 2.345
Authors: Christoph Lange; Ibrahim Abubakar; Jan-Willem C Alffenaar; Graham Bothamley; Jose A Caminero; Anna Cristina C Carvalho; Kwok-Chiu Chang; Luigi Codecasa; Ana Correia; Valeriu Crudu; Peter Davies; Martin Dedicoat; Francis Drobniewski; Raquel Duarte; Cordula Ehlers; Connie Erkens; Delia Goletti; Gunar Günther; Elmira Ibraim; Beate Kampmann; Liga Kuksa; Wiel de Lange; Frank van Leth; Jan van Lunzen; Alberto Matteelli; Dick Menzies; Ignacio Monedero; Elvira Richter; Sabine Rüsch-Gerdes; Andreas Sandgren; Anna Scardigli; Alena Skrahina; Enrico Tortoli; Grigory Volchenkov; Dirk Wagner; Marieke J van der Werf; Bhanu Williams; Wing-Wai Yew; Jean-Pierre Zellweger; Daniela Maria Cirillo Journal: Eur Respir J Date: 2014-03-23 Impact factor: 16.671
Authors: Agnes Binagwaho; Roger Bate; Michel Gasana; Corine Karema; Yves Mucyo; John Patrick Mwesigye; Floribert Biziyaremye; Cameron T Nutt; Claire M Wagner; Paul Jensen; Amir Attaran Journal: PLoS Med Date: 2013-07-02 Impact factor: 11.069