Table 5.

Percentage of artemisinin-containing antimalarial samples that were poor quality by risk factor, and ORs of being poor quality based on artemisinin component only

	N	Number of poor quality	Percentage poor quality	Unadjusted OR	P value
Outlet type					0.3
Pharmacies	1,601	85	5.7 (4.6–7.1)	1
Drug stores	124	4	3.2 (1.3–7.9)	0.6 (0.2–1.6)
General retailers	5	0	0	−
Location					0.2
Urban	1,621	85	5.0 (3.4–7.4)	1
Rural	109	4	2.3 (0.8–6.8)	0.5 (0.1–1.5)
Monotherapy/ACT					0.5
Monotherapy	1,620	86	2.9 (1.2–6.7)	1
ACT	110	3	4.1 (2.7–6.3)	1.4 (0.5–4.1)
Generic type					0.02
Artemether	599	16	2.1 (0.9–4.8)	1
Artemisinin	298	4	2.5 (0.5–12.7)	1.2 (0.2–9.3)
Artesunate	539	46	6.1 (2.7–13.1)	3.1 (0.7–12.4)
Dihydroartemisinin	294	23	4.7 (2.6–8.4)	2.3 (1.4–4.0)
WHO prequalified					0.002
No	1,442	85	5.4 (3.4–8.5)	1
Yes	308	4	0.5 (0.1–1.9)	0.1 (0.02–0.4)
Dose form					0.02
Tablet	1,385	55	3.4 (1.8–6.3)	1
Suspension	192	11	5.4 (1.7–15.8)	1.6 (0.4–7.3)
Injectable	107	3	3.0 (1.3–6.9)	0.9 (0.3–2.8)
Granule	46	20	29.6 (9.9–61.5)	10.6 (1.7–65.9)
Stated region of manufacture					0.1
Asia	850	32	3.0 (1.8–5.1)	1
Africa	435	15	2.3 (0.9–5.4)	0.8 (0.4–1.6)
Europe	412	41	10.2 (4.3–22.1)	3.6 (1.0–13.3)
United States	17	1	0.01 (0.0–5.0)	0.2 (0.02–1.7)
Expired at date of purchase					–
Not expired	1,703	89	4.2 (2.8–6.3)	1
Expired	26	0	0	Omitted
Expired at date of analysis					0.05
Not expired	644	10	1.8 (0.7–4.8)	1
Expired	1,083	79	5.2 (3.5–7.8)	3.0 (1–8.7)
Price per AETD					0.03
< 25th percentile	133	9	1.5 (0.6–3.9)	1
≥ 25th percentile	1,599	80	4.9 (3.3–7.2)	3.3 (1.1–9.8)

ACT = artemisinin-based combination therapy; AETD = adult equivalent treatment dose; WHO = World Health Organization.

Poor quality defined as less than 85% or greater than 115% of stated API.