title: Quality of antimalarials at the epicenter of antimalarial drug resistance: results from an overt and mystery client survey in Cambodia.
abstract: Widespread availability of monotherapies and falsified antimalarials is thought to have contributed to the historical development of multidrug-resistant malaria in Cambodia. This study aimed to document the quality of artemisinin-containing antimalarials (ACAs) and to compare two methods of collecting antimalarials from drug outlets: through open surveyors and mystery clients (MCs). Few oral artemisinin-based monotherapies and no suspected falsified medicines were found. All 291 samples contained the stated active pharmaceutical ingredient (API) of which 69% were considered good quality by chemical analysis. Overall, medicine quality did not differ by collection method, although open surveyors were less likely to obtain oral artemisinin-based monotherapies than MCs. The results are an encouraging indication of the positive impact of the country's efforts to tackle falsified antimalarials and artemisinin-based monotherapies. However, poor-quality medicines remain an ongoing challenge that demands sustained political will and investment of human and financial resources.
authors.forename: Shunmay
authors.initials: S
authors.lastname: Yeung
authors.forename: Harriet L S
authors.initials: HLS
authors.lastname: Lawford
authors.forename: Patricia
authors.initials: P
authors.lastname: Tabernero
authors.forename: Chea
authors.initials: C
authors.lastname: Nguon
authors.forename: Albert
authors.initials: A
authors.lastname: van Wyk
authors.forename: Naiela
authors.initials: N
authors.lastname: Malik
authors.forename: Mikhael
authors.initials: M
authors.lastname: DeSousa
authors.forename: Ouk
authors.initials: O
authors.lastname: Rada
authors.forename: Mam
authors.initials: M
authors.lastname: Boravann
authors.forename: Prabha
authors.initials: P
authors.lastname: Dwivedi
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hostetler
authors.forename: Isabel
authors.initials: I
authors.lastname: Swamidoss
authors.forename: Michael D
authors.initials: MD
authors.lastname: Green
authors.forename: Facundo M
authors.initials: FM
authors.lastname: Fernandez
authors.forename: Harparkash
authors.initials: H
authors.lastname: Kaur
mesh_terms: D000962:Antimalarials / Q000737:chemistry* / Q000191:economics / Q000592:standards; D002160:Cambodia / Q000453:epidemiology; D003132:Commerce; D003625:Data Collection; D004348:Drug Labeling; D004349:Drug Packaging; D004351:Drug Resistance; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D010594:Pharmacies; D010963:Plasmodium falciparum / Q000187:drug effects*; D011786:Quality Control; D012307:Risk Factors
chemical_list: D000962:Antimalarials