Table 4. Description of all samples purchased using mystery clients and overt sampling approaches in Enugu, Nigeria; N = 2865.
| Mystery clients | Overt | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Variable | Total samples | Pharmacies | PMVs | p-value a | PHFs | Total samples | Pharmacies | PMVs | p-value a |
| Combination therapies | |||||||||
| AM-LUM | 1145 (62.9%) | 509 (59.0%) | 597 (66.0%) | 0.04 | 39 (73.6%) | 581 (67.6%) | 344 (66.4%) | 237 (69.3%) | 0.44 |
| AS-ADQ | 239 (13.1%) | 117 (13.6%) | 108 (11.9%) | 0.72 | 14 (26.4%) | 78 (9.1%) | 48 (9.3%) | 30 (8.8%) | 0.97 |
| AS-MEF | 47 (2.6%) | 32 (3.7%) | 15 (1.7%) | 0.71 | 0 | 25 (2.9%) | 19 (3.7%) | 6 (1.8%) | 0.81 |
| AS-SULDOX-PYR | 12 (0.7%) | 8 (0.9%) | 4 (0.4%) | 0.97 | 0 | 4 (0.5%) | 2 (0.4%) | 2 (0.6%) | 0.97 |
| AS-SULFMEX-PYR | 28 (1.5%) | 24 (2.8%) | 4 (0.4%) | 0.93 | 0 | 21 (2.4%) | 18 (3.5%) | 3 (0.9%) | 0.83 |
| DHA-PIP | 344 (18.9%) | 171 (19.8%) | 173 (19.1%) | 0.85 | 0 | 151 (17.6%) | 87 (16.8%) | 64 (18.7%) | 0.73 |
| ART-PIP | 1 (0.1%) | 0 | 1 (0.1%) | - | 0 | 0 | 0 | 0 | |
| DHA-ADQ | 3 (0.2%) | 1 (0.1%) | 2 (0.2%) | - | 0 | 0 | 0 | 0 | |
| Total | 1819 b | 862 | 904 | 53 | 860 b | 518 | 342 | ||
| All monotherapies (suspensions n = 36, injectables n = 1, and tablets n = 149) | |||||||||
| AM | 1 (0.8%) | 0 | 0 | 0 | 1 (50.0%) | 0 | 0 | 0 | |
| DHA | 14 (11.0%) | 10 (21.3%) | 4 (5.1%) | 0.1 | 0 | 1 (1.7%) | 0 | 1 (4.3%) | 1.00 |
| AS | 112 (88.2%) | 37 (78.7%) | 74 (94.9%) | <0.001 | 1 (50.0%) | 58 (98.3%) | 36 (100.0%) | 22 (95.7%) | 0.07 |
| Total | 127 b | 47 | 78 | 2 | 59 b | 36 | 23 | ||
| Monotherapy tablets (n = 149) | |||||||||
| AM | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||
| DHA | 13 (12.1%) | 10 (23.3%) | 3 (4.8%) | <0.01 | 0 | 1 (2.4%) | 0 | 1 (5.0%) | 0.48 |
| AS | 94 (87.9%) | 33 (76.7%) | 60 (95.2%) | <0.01 | 1 (100.0%) | 41 (97.6%) | 22 (100.0%) | 19 (95.0%) | 0.48 |
| Total | 107 b | 43 | 63 | 1 | 42 b | 22 | 20 | ||
| Dose form | |||||||||
| Tablets | 1710 (87.9%) | 792 (87.2%) | 866 (88.1%) | 0.57 | 52 (94.5%) | 774 (84.2%) | 446 (80.5%) | 328 (89.9%) | <0.001 |
| Capsules | 5 (0.3%) | 4 (4.4%) | 0 | - | 1 (1.8%) | 3 (0.3%) | 2 (0.4%) | 1 (0.3%) | |
| Suspensions | 187 (9.6%) | 87 (9.6%) | 99 (10.1%) | 0.92 | 1 (1.8%) | 131 (14.3%) | 97 (17.5%) | 34 (9.3%) | 0.24 |
| Injectables | 1 (0.1%) | 0 | 0 | - | 1 (1.8%) | 0 | 0 | 0 | |
| Granules/powders | 40 (2.1%) | 24 (2.6%) | 16 (1.6%) | 0.83 | 0 | 11 (1.2%) | 9 (1.6%) | 2 (0.5%) | 0.91 |
| Soft gels | 3 (0.2%) | 1 (0.1%) | 2 (0.2%) | - | 0 | 0 | 0 | 0 | |
| Total | 1946 | 908 | 983 | 55 | 919 | 554 | 365 | ||
| WHO prequalification | |||||||||
| Not WHO prequalified | 1386 (71.2%) | 727 (80.0%) | 638 (64.9%) | <0.001 | 21 (38.2%) | 702 (76.4%) | 450 (81.2%) | 252 (69.0%) | <0.001 |
| Stated region of manufacture | |||||||||
| Africa | 381 (19.6%) | 182 (20.0%) | 182 (18.5%) | 0.66 | 17 (30.9%) | 168 (18.3%) | 96 (17.3%) | 72 (19.7%) | 0.69 |
| Asia | 1324 (68.0%) | 619 (68.2%) | 671 (68.3%) | 1 | 34 (61.8%) | 644 (70.1%) | 387 (69.9%) | 257 (70.4%) | 0.89 |
| Europe | 90 (4.6%) | 65 (7.2%) | 25 (2.5%) | 0.39 | 0 | 60 (6.5%) | 47 (8.5%) | 13 (3.6%) | 0.30 |
| North America | 149 (7.7%) | 42 (4.6%) | 104 (10.6%) | 0.25 | 3 (5.5%) | 44 (4.8%) | 21 (3.8%) | 23 (6.3%) | 0.70 |
| Unknown | 2 (0.1%) | 0 | 1 (0.1%) | - | 1 (1.8%) | 3 (0.3%) | 3 (0.5%) | 0 | |
| Total | 1946 | 908 | 983 | 55 | 919 | 554 | 365 | ||
AM = artemether; ADQ = -amodiaquine; ART = artemisinin; AS = artesunate; DHA = dihydroartemisinin; LUM = lumefantrine; MEF = mefloquine; PIP = piperaquine; PYR = pyrimethamine; SULDOX = sulfadoxine; SULFMEX = sulfamethoxypyridazine; PHCs = public health facilities; PMVs = patent medicine vendors; WHO = World Health Organisation.
aonly pharmacies and patent medicine vendors were compared as public health facilities were not visited during the overt sampling approach.
bno significant difference (p = 0.29) between the proportion of monotherapy tablets purchased using the mystery clients (5.5%) and overt (4.6%) sampling approaches.