ArticleBMJ global health2025
Assessing the quality of antimalarial drugs in Equatorial Guinea: a follow-up study.
Article in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionPoor-quality antimalarial medications, including falsified and substandard formulations, pose significant public health risks, contributing to ineffective treatment and potential drug resistance. Our research conducted in 2013 on Bioko Island, Equatorial Guinea (EG), found 9.6% (n=61) of the artemisinin-containing antimalarials (ACAs) purchased were of poor quality. This study aimed to update the quality of all sold antimalarials and extend to include regions on the mainland.
methodsA total of 637 samples, 564 ACAs and 73 non-ACAs, were purchased from 424 outlets on Bioko Island and mainland EG using a mystery client sampling approach. Samples were analysed for content using high-performance liquid chromatography with diode-array detection and classified as acceptable, substandard or falsified based on pharmacopoeia tolerance limits. Additionally, bioavailability was assessed through dissolution testing for a select number of samples.
resultsOverall, 40.5% of the samples were of acceptable quality, 31.2% were substandard and 28.3% were falsified. Regional differences showed a higher prevalence of falsified samples in Bata, Mangomo, Evinayong and Ebebiyín cities on the mainland (30.9%) compared with Bioko Island (25.6%). Artemether/lumefantrine, the first-line treatment for malaria in EG, showed 25.7% were of acceptable quality, 48.2% substandard and 26.1% falsified. Artemisinin monotherapy tablets had the highest rate of falsification (56.8%). For non-ACAs, 13.3% of sulfadoxine/pyrimethamine tablets were of acceptable quality, 48.9% substandard and 37.8% falsified. All quinine syrups were falsified, and most quinine tablets (87.5%) and injections (75.0%) were substandard.
conclusionThe prevalence of substandard and falsified antimalarials in EG has alarmingly increased from 9% in 2013 to 59.5% in 2018, highlighting the urgent need for enhanced regulatory measures. Immediate actions should include strengthening drug quality surveillance, particularly in private sector pharmacies, and implementing low-cost medicine screening methods for early detection of poor-quality medications. Ensuring the quality of antimalarials is critical to maintaining the efficacy of malaria control programmes and preventing the development of drug resistance.
Indexed as
Identifiers
What OpenQuestion holds
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.