Table 4.
Characteristics of artemisinin-containing antimalarial samples analyzed, by generic content
| Artemether (N = 604) | Artemisinin (N = 248) | Artesunate (N = 541) | Dihydroartemisinin (N = 294) | All artemisinin-containing antimalarials (N = 1,737) | Selected ACTs for which partner drug was also analyzed (N = 1,281) | |
|---|---|---|---|---|---|---|
| Outlet type | ||||||
| Pharmacies | 42.8 (25.9–61.6) | 53.8 (33.0–73.3) | 33.4 (16.6–56.0) | 34.1 (19.8–51.9) | 39.1 (23.6–57.1) | 40.9 (25.7–57.9) |
| Drug stores | 48.5 (30.7–66.8) | 46.3 (26.7–67.0) | 66.6 (44.1–83.4) | 65.9 (48.1–80.2) | 58.1 (39.9–74.4) | 55.2 (37.9–71.3) |
| General retailers | 8.7 (2.4–27.4) | 0 | 0 | 0 | 2.8 (0.7–10.5) | 4.0 (1.0–14.5) |
| Location | ||||||
| Urban | 63.2 (43.3–79.4) | 86.8 (53.4–97.4) | 65.3(28.2–90.0) | 66.8 (32.8–89.3) | 67.7 (41.8–85.9) | 71.8 (52.4–85.4) |
| Rural | 36.8 (20.6–56.7) | 13.2 (2.6–46.6) | 34.7 (10.0–71.8) | 33.2 (10.8–67.2) | 32.3 (14.1–58.2) | 28.3 (14.6–47.6) |
| Monotherapy/ACT | ||||||
| Monotherapy | 8.5 (4.6–15.2) | 0 | 0.9 (0.5–1.7) | 0 | 3.0 (1.7–5.2) | 0 |
| ACT | 91.5 (84.8–95.4) | 100 | 99.1 (98.4–99.5) | 100 | 97.0 (94.9–98.3) | 100 |
| Generic name | ||||||
| Artemether | − | − | − | − | 31.7 (23.0–41.9) | 41.6 (33.6–50.1) |
| Artemisinin | − | − | − | − | 12.9 (9.2–17.7) | 12.5 (9.3–16.4) |
| Artesunate | − | − | − | − | 37.4 (27.9–48.0) | 20.0 (15.0–26.0) |
| Dihydroartemisinin | − | − | − | − | 18.1 (14.2–22.7) | 26.0 (17.9–36.1) |
| Dosage form | ||||||
| Tablet | 63.9 (52.1–74.2) | 100 | 93.4 (87.2–96.8) | 100 | 86.1 (80.6–90.3) | 84.3 (77.6–89.3) |
| Suspension | 27.6 (18.8–38.5) | 0 | 0 | 0 | 8.7 (6.1–12.4) | 12.6 (9.5–16.5) |
| Injectable | 8.5 (4.6–15.2) | 0 | 0.7 (0.4–1.4) | 0 | 3.0 (1.7–5.2) | 0 |
| Granule | 0 | 0 | 5.9 (2.6–12.8) | 0 | 2.2 (1.0–5.0) | 3.2 (1.4–7.1) |
| WHO prequalified | 61.4 (49.5–72.2) | 0 | 16.8 (7.9–32.2) | 0 | 25.7 (18.7–34.4) | 27.7 (19.4–38.0) |
| Region of stated country of manufacture | ||||||
| Asia | 21.2 (12.5–33.6) | 99.8 (99.2–99.9) | 15.9 (7.1–31.7) | 100 | 45.3 (41.1–49.5) | 49.0 (40.1–58.0) |
| Africa | 31.9 (22.4–43.2) | 0.0 (0.0–0.6) | 46.8 (27.4–67.1) | 0 | 27.6 (20.4–36.2) | 12.4 (9.3–16.4) |
| Europe | 26.6 (20.0–34.5) | 0.1 (0.0–0.8) | 37.3 (21.7–56.0) | 0 | 20.7 (15.0–27.8) | 29.5 (23.3–36.6) |
| United States | 19.3 (7.7–40.6) | 0 | 0.0 (0.0–0.7) | 0 | 6.1 (2.2–16.2) | 8.8 (3.2–22.1) |
| Unknown | 1.1 (0.5–2.1) | 0 | 0.0 (0.0–0.4) | 0 | 0.4 (0.2–0.7) | 0.3 (0.1–0.7) |
| Expired at time of purchase | 5.3 (2.0–13.3) | 0.2 (0.0–1.0) | 0.4 (0.0–1.8) | 1.2 (0.5–2.7) | 2.0 (0.8–5.1) | 2.8 (1.1–6.8) |
| Expired at time of analysis | 76.5 (66.2–74.3) | 29.3 (18.3–43.4) | 57.4 (35.6–76.6) | 100 | 67.4 (56.5–76.8) | 83.3 (75.8–88.8) |
| Price per AETD | ||||||
| < 25th percentile | 39.4 (25.0–56.0) | 0.3 (0.0–1.0) | 30.2 (7.6–69.4) | 2.1 (0.3–14.4) | 24.2 (12.6–41.4) | 18.2 (10.3–30.0) |
ACTs = artemisinin-based combination therapies; AETD = adult equivalent treatment dose; DHA = dihydroartemisinin; WHO = World Health Organization.