Table 4.
Bivariate (crude) and multivariate (adjusted) model of association between poor quality ACAs (as defined by API < 85% or ≥ 115%) and exposure variables
| Total number of samples | Number (%) of poor quality samples (API < 85% or ≥ 115%) | Crude OR (95% CI) | P value | Adjusted OR (95% CI) | P value | ||||
|---|---|---|---|---|---|---|---|---|---|
| N = 291 | N = 91 (%) | ||||||||
| Collection method | |||||||||
| Census | 212 | 67 | (31.6) | 1.0 | − | − | − | − | − |
| MC | 79 | 24 | (30.4) | 0.96 | (0.44, 2.08) | 0.912 | 0.74 | (0.31, 1.77) | 0.471 |
| Brand name | |||||||||
| Malarine (all age groups) | 178 | 44 | (24.7) | 1.0 | − | − | − | − | − |
| Other brands | 113 | 47 | (41.6) | 2.41 | (1.26, 4.66) | 0.012** | 1.65 | (0.69, 3.98) | 0.236* |
| Dose form | |||||||||
| Oral tablet | 255 | 72 | (28.2) | 1.0 | − | − | − | − | − |
| Liquid injection/ampoule | 36 | 19 | (52.8) | 2.63 | (1.08, 6.42) | 0.036** | 3.39 | (0.94, 12.25) | 0.061* |
| API | |||||||||
| Artesunate | 233 | 60 | (25.8) | 1.0 | − | − | − | − | − |
| Other APIs | 58 | 31 | (53.5) | 3.21 | (2.31, 4.48) | < 0.0001** | 0.90 | (0.22, 3.64) | 0.877 |
| Artesunate form† | |||||||||
| Co-blister with Mefloquine | 204 | 48 | (23.5) | 1.0 | − | − | − | − | − |
| Artesunate monotherapy | 29 | 12 | (41.4) | 2.81 | (1.34, 5.91) | 0.010** | − | − | − |
| Location of outlet | |||||||||
| Inside containment area | 134 | 41 | (30.6) | 1.0 | − | − | − | − | − |
| Outside containment area | 157 | 50 | (31.9) | 1.09 | (0.52, 2.26) | 0.802 | 1.09 | (0.63, 1.87) | 0.740 |
| Expired at time of analysis? | |||||||||
| No | 188 | 49 | (26.1) | 1.0 | − | − | − | − | − |
| Yes | 72 | 29 | (40.3) | 1.84 | (0.92, 3.66) | 0.080* | 2.56 | (1.29, 5.07) | 0.011** |
| Price (Riel) | |||||||||
| > 3,500 | 202 | 62 | (30.7) | 1.0 | − | − | − | − | − |
| ≤ 3,500 | 77 | 27 | (35.1) | 1.16 | (0.72, 1.88) | 0.518 | 1.65 | (1.00, 2.72) | 0.049** |
| Qualification of outlet owner‡ | |||||||||
| No training | 35 | 13 | (37.1) | 1.0 | − | − | − | − | − |
| At least some training | 100 | 30 | (30.0) | 0.73 | (0.37, 1.41) | 0.305 | − | − | − |
| Storage conditions‡ | |||||||||
| Cabinet inside shop | 192 | 60 | (31.3) | 1.0 | − | − | − | − | − |
| Other storage conditions | 16 | 7 | (43.8) | 1.71 | (0.81, 3.60) | 0.138* | − | − | − |
| Type of outlet‡ | |||||||||
| Pharmacy | 66 | 21 | (31.8) | 1.0 | − | − | − | − | − |
| Other outlet types | 142 | 46 | (32.4) | 1.03 | (0.56, 1.87) | 0.924 | − | − | − |
API = active pharmaceutical ingredient; ACAs = artemisinin-containing antimalarials; CI = confidence interval; OR = odds ratio.
*
P ≤ 0.25.
**
P < 0.05.
†
Data collected for artesunate samples only.
‡
Data collected during Census only.