ArticleThe American journal of tropical medicine and hygiene2015
Estimated under-five deaths associated with poor-quality antimalarials in sub-Saharan Africa.
Article in The American journal of tropical medicine and hygiene, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
66 citing papers in PubMed, 4 syntheses or guidelines pooled it, 155 citations in OpenAlex.
- Artemisinin-Based Combination Therapies in East Africa: A Systematic Review of Quality, Clinical Efficacy, and Regulatory Progress Towards Sustainable Malaria Control.Tropical medicine & international health : TM & IH · 2026Pooled it
- The impact of global falsified medicines regulation on healthcare stakeholders in the legitimate pharmaceutical supply chain: a systematic review.Frontiers in medicine · 2024Pooled it
- Health, Economic, and Social Impacts of Substandard and Falsified Medicines in Low- and Middle-Income Countries: A Systematic Review of Methodological Approaches.The American journal of tropical medicine and hygiene · 2023Pooled it
- A systematic review of substandard, falsified, unlicensed and unregistered medicine sampling studies: a focus on context, prevalence, and quality.BMJ global health · 2020Pooled it
- Pharmaceutical quality of artemether-lumefantrine in Rwanda's public health supply chain: a cross-sectional post-market surveillance study.Malaria journal · 2026Article
- A novel framework for quantifying the clinical impact of substandard and falsified antimicrobials: Application to typhoid fever.PLOS global public health · 2026Article
- Logics of acquiring medicines from informal retailers in four African countries.Global health action · 2025Article
- Child Mortality and Nutritional Risks in Rural Chad: A Community-Based Cross-Sectional Study in Béré.International journal of environmental research and public health · 2025Article
- Assessing knowledge, attitudes, and practices and demand-side interventions for combating substandard and falsified medicines: a scoping review.Journal of pharmaceutical policy and practice · 2025Review
- Perceptions and practices on substandard and falsified medicines in humans and animals in Wakiso district, Uganda: A qualitative study.PloS one · 2025Article
- Knowledge, attitudes and practices on substandard and falsified medicines for human and animal use in Wakiso district, Uganda.Journal of pharmaceutical policy and practice · 2025Article
- A Comprehensive Assessment of Quality of Antimalarial Medicines in Mainland Tanzania: Insights from Five Years of Postmarket Surveillance.The American journal of tropical medicine and hygiene · 2024Article
- The role of constraints and information gaps in driving risky medicine purchasing practices in four African countries.Health policy and planning · 2024Article
- A narrative review on problems in product quality, regulatory system constraints, and the concept of quality by design as a solution for quality assurance of African medicines.Frontiers in medicine · 2024Review
- Strengthening regulation for medical products in Tanzania: An assessment of regulatory capacity development, 1978-2020.PLOS global public health · 2024Article
- The uncertain role of substandard and falsified medicines in the emergence and spread of antimicrobial resistance.Nature communications · 2023Review
- Quality of medicines in Sri Lanka: a retrospective review of safety alerts.BMC health services research · 2023Article
- Impact of ignoring sampling design in the prediction of binary health outcomes through logistic regression: evidence from Malawi demographic and health survey under-five mortality data; 2000-2016.BMC public health · 2023Article
- Pharmacopeial quality of artemether-lumefantrine anti-malarial agents in Uganda.Malaria journal · 2023Article
- Improved knowledge on substandard and falsified (SF) medical products through a dedicated course for pharmacy students at three universities in sub-Saharan Africa.BMJ global health · 2023Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
Many antimalarials sold in sub-Saharan Africa are poor-quality (falsified, substandard, or degraded), and the burden of disease caused by this problem is inadequately quantified. In this article, we estimate the number of under-five deaths caused by ineffective treatment of malaria associated with consumption of poor-quality antimalarials in 39 sub-Saharan countries. Using Latin hypercube sampling our estimates were calculated as the product of the number of private sector antimalarials consumed by malaria-positive children in 2013; the proportion of private sector antimalarials consumed that were of poor-quality; and the case fatality rate (CFR) of under-five malaria-positive children who did not receive appropriate treatment. An estimated 122,350 (interquartile range [IQR]: 91,577-154,736) under-five malaria deaths were associated with consumption of poor-quality antimalarials, representing 3.75% (IQR: 2.81-4.75%) of all under-five deaths in our sample of 39 countries. There is considerable uncertainty surrounding our results because of gaps in data on case fatality rates and prevalence of poor-quality antimalarials. Our analysis highlights the need for further investigation into the distribution of poor-quality antimalarials and the need for stronger surveillance and regulatory efforts to prevent the sale of poor-quality antimalarials.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.