P Nkoli Mandoko1, V Sinou2, D Moke Mbongi3, D Ngoyi Mumba1, G Kahunu Mesia4, J Losimba Likwela5, S Bi Shamamba Karhemere1, L Muepu Tshilolo3, J-J Tamfum Muyembe1, D Parzy6. 1. Institut national de recherche biomédicale (INRB), Kinshasa, The Democratic Republic of the Congo. 2. UMR-MD3, Aix-Marseille université, faculté de pharmacie, 13005 Marseille, France. Electronic address: veronique.sinou@univ-amu.fr. 3. Centre de formation et d'appui sanitaire (CEFA)/centre hospitalier Monkole, Mont-Ngafula, Kinshasa, The Democratic Republic of the Congo. 4. Unité de pharmacologie clinique et pharmacovigilance, facultés de médecine et de pharmacie, université de Kinshasa, Kinshasa, The Democratic Republic of the Congo. 5. Département de santé publique, faculté de médecine et de pharmacie, université de Kisangani, Kisangani, The Democratic Republic of the Congo; Programme national de lutte contre le paludisme, Kinshasa, The Democratic Republic of the Congo. 6. Département de biologie, K-Plan, Grand Luminy Technopôle, 13288 Marseille cedex, France.
Abstract
OBJECTIVE: Artemisinin-based combination therapies have been available since 2005 in the Democratic Republic of the Congo to treat malaria and to overcome the challenge of anti-malarial drug resistance as well as to improve access to effective treatments. The private sector is the primary distribution source for anti-malarial drugs and thus, has a key position among the supply chain actors for a rational and proper use of anti-malarial drugs. We aimed to assess access to nationally recommended anti-malarial drugs in private sector pharmacies of the capital-city of Kinshasa. METHOD: We performed a cross-sectional survey of 404 pharmacies. RESULTS: Anti-malarial drugs were stocked in all surveyed pharmacies. Non-artemisinin-based anti-malarial therapies such as quinine or sulfadoxine-pyrimethamine, were the most frequently stocked drugs (93.8% of pharmacies). Artemisinin-based combination therapies were stocked in 88% of pharmacies. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies), but less than 3% were quality-assured products. Other non-officially recommended artemisinin-based therapies including oral monotherapies were widely available. CONCLUSION: Artemisinin-based combination therapies were widely available in the private pharmacies of Kinshasa. However, the private sector does not guarantee the use of nationally recommended anti-malarial drugs nor does it give priority to quality-assured anti-malarial drugs. These practices contribute to the risk of emergence and spread of resistance to anti-malarial drugs and to increasing treatment costs.
OBJECTIVE:Artemisinin-based combination therapies have been available since 2005 in the Democratic Republic of the Congo to treat malaria and to overcome the challenge of anti-malarial drug resistance as well as to improve access to effective treatments. The private sector is the primary distribution source for anti-malarial drugs and thus, has a key position among the supply chain actors for a rational and proper use of anti-malarial drugs. We aimed to assess access to nationally recommended anti-malarial drugs in private sector pharmacies of the capital-city of Kinshasa. METHOD: We performed a cross-sectional survey of 404 pharmacies. RESULTS: Anti-malarial drugs were stocked in all surveyed pharmacies. Non-artemisinin-based anti-malarial therapies such as quinine or sulfadoxine-pyrimethamine, were the most frequently stocked drugs (93.8% of pharmacies). Artemisinin-based combination therapies were stocked in 88% of pharmacies. Artemether-lumefantrine combinations were the most frequently dispensed drugs (93% of pharmacies), but less than 3% were quality-assured products. Other non-officially recommended artemisinin-based therapies including oral monotherapies were widely available. CONCLUSION:Artemisinin-based combination therapies were widely available in the private pharmacies of Kinshasa. However, the private sector does not guarantee the use of nationally recommended anti-malarial drugs nor does it give priority to quality-assured anti-malarial drugs. These practices contribute to the risk of emergence and spread of resistance to anti-malarial drugs and to increasing treatment costs.
Authors: Don Jethro Mavungu Landu; Michel Frédérich; Joseph Manzambi Kuwekita; Christian Bongo-Pasi Nswe; J K Mbinze; Sophie Liégeois; Nicodème Kalenda Tshilombo; Mineze Kwete Minga; Patient Ciza Hamuli; Philippe Hubert; Roland Marini Djang'eing'a Journal: Int Health Date: 2020-07-01 Impact factor: 2.473