Table 7.

Percentage of ACT samples that were poor quality by risk factor, and ORs of being poor quality based on both artemisinin and partner components for selected ACTs

	N	Number of poor quality	Percentage poor quality	Unadjusted OR	P value
Outlet type					0.4
Pharmacies	1,180	124	11.0 (9.6–12.6)	1
Drug stores	91	11	13.9 (7.4–24.5)	1.3 (0.6–2.6)
General retailers	5	0	0	−
Location					0.6
Urban	1,202	126	11.2 (8.3–15.0)	1
Rural	74	9	14.6 (4.7–36.8)	1.35 (0.38–4.84)
Generic type					0.04
Artemether	499	17	3.1 (1.3–7.5)	1
Artemisinin	173	14	11.6 (5.3–23.5)	4.0 (1.3–12.9)
Artesunate	310	65	19.2 (11.6–30.1)	7.3 (2.0–26.6)
Dihydroartemisinin	294	39	21.1 (11.1–36.4)	8.3 (2.6–25.9)
WHO prequalified					< 0.001
No	1,015	130	16.4 (11.3–23.2)	1
Yes	261	5	0.8 (0.3–2.5)	0.04 (0.01–0.1)
Dose form					0.04
Tablet	1,040	99	11.8 (7.1–18.9)	1
Suspension	192	12	8.6 (2.9–22.6)	0.7 (0.2–2.6)
Injectable	0	0	−	−
Granule	44	24	35.1 (10.1–72.1)	3.9 (0.7–21.9)
Stated region of manufacture					0.05
Asia	657	56	14.5 (7.9–25.2)	1
Africa	186	12	8.7 (2.9–22.9)	1.5 (0.6–4.0)
Europe	404	66	13.2 (7.2–23.1)	3.0 (0.9–10.1)
United States	17	1	0.6 (0.0–5.1)	0.1 (0.01–1.5)
Expired at date of purchase					0.2
Not expired	1,257	134	12.3 (8.1–18.2)	1
Expired	18	1	3.0 (0.3–22.4)	10.2 (0.02–2.1)
Expired at date of analysis					0.02
Not expired	303	15	5.7 (2.8–11.3)	1
Expired	972	120	13.5 (8.8–20.2)	2.57 (1.20–5.5)
Price per AETD					0.05
< 25th percentile	70	8	4.5 (1.3–15.0)	1
≥ 25th percentile	1,206	127	13.7 (9.4–16.7)	3.36 (0.9–11.6)

ACT = artemisinin-based combination therapies; AETD = adult equivalent treatment dose. OR = odds ratio; WHO = World Health Organization.

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