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      Manslaughter by Fake Artesunate in Asia—Will Africa Be Next?

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          Abstract

          Fake artesunate could compromise the hope that artemisinin-based combination therapy offers for malaria control in Africa and Asia.

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          Most cited references23

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          Versatile new ion source for the analysis of materials in open air under ambient conditions.

          Robert Cody, James Laramée, H. Dupont Durst (2005)
          A new ion source has been developed for rapid, noncontact analysis of materials at ambient pressure and at ground potential. The new source, termed DART (for "Direct Analysis in Real Time"), is based on the reactions of electronic or vibronic excited-state species with reagent molecules and polar or nonpolar analytes. DART has been installed on a high-resolution time-of-flight mass spectrometer (TOFMS) that provides improved selectivity and accurate elemental composition assignment through exact mass measurements. Although DART has been applied to the analysis of gases, liquids, and solids, a unique application is the direct detection of chemicals on surfaces without requiring sample preparation, such as wiping or solvent extraction. DART has demonstrated success in sampling hundreds of chemicals, including chemical agents and their signatures, pharmaceutics, metabolites, peptides and oligosaccharides, synthetic organics, organometallics, drugs of abuse, explosives, and toxic industrial chemicals. These species were detected on various surfaces, such as concrete, asphalt, human skin, currency, airline boarding passes, business cards, fruits, vegetables, spices, beverages, body fluids, horticultural leaves, cocktail glasses, and clothing. DART employs no radioactive components and is more versatile than devices using radioisotope-based ionization. Because its response is instantaneous, DART provides real-time information, a critical requirement for screening or high throughput.
          Article 0 comments Cited 355 times – based on 0 reviews     Review now
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            Fake antimalarials in Southeast Asia are a major impediment to malaria control: multinational cross-sectional survey on the prevalence of fake antimalarials.

            A M Dondorp, P N Newton, M Mayxay … (2004)
            To assess the prevalence of counterfeit antimalarial drugs in Southeast (SE) Asia. Cross-sectional survey. Pharmacies and shops selling antimalarial drugs in Myanmar (Burma), Lao PDR, Vietnam, Cambodia and Thailand. Proportion of artemisinin derivatives or mefloquine containing drugs of substandard quality. Of the 188 tablet packs purchased which were labelled as 'artesunate' 53% did not contain any artesunate. All counterfeit artesunate tablets were labelled as manufactured by 'Guilin Pharma', and refinements of the fake blisterpacks made them often hard to distinguish from their genuine counterparts. No other artemisinin derivatives were found to be counterfeited. Of the 44 mefloquine samples, 9% contained <10% of the expected amount of active ingredient. An alarmingly high proportion of antimalarial drugs bought in pharmacies and shops in mainland SE Asia are counterfeit, and the problem has increased significantly compared with our previous survey in 1999-2000. This is a serious threat to public health in the region.
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              Fake artesunate in southeast Asia.

              Peter S. White, Douglas R. Green, S Prakongpan … (2001)
              Artesunate is a key antimalarial drug in the treatment of multidrug-resistant Plasmodium falciparum malaria in southeast Asia. We investigated the distribution of counterfeit artesunate tablets by use of the validated, simple, and inexpensive Fast Red TR dye technique. We also aimed to identify distinguishing characteristics of the fake drugs. Of 104 shop-bought "artesunate" samples from Cambodia, Laos, Myanmar (Burma), Thailand, and Vietnam, 38% did not contain artesunate. Characteristics such as cost and physical appearance of the tablets and packaging reliably predicted authenticity. The illicit trade in counterfeit antimalarials is a great threat to the lives of patients with malaria. The dye test will assist national malaria control authorities in urgently needed campaigns to stop this murderous trade.
              Article 0 comments Cited 55 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): PLoS Med
                Journal ID (publisher-id): pmed
                Title: PLoS Medicine
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Print): 1549-1277
                ISSN (Electronic): 1549-1676
                Publication date (Print): June 2006
                Publication date (Electronic): 13 June 2006
                Volume: 3
                Issue: 6
                Electronic Location Identifier: e197
                Author notes

                Competing Interests: The authors declare that they have no competing interests. The authors' funding bodies had no role in the preparation of this article.

                P. N. Newton, R. McGready, S. Proux, N. P. J. Day, F. Nosten, and N. J. White are at the Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Churchill Hospital, Oxford, United Kingdom. P. N. Newton, N. P. J. Day, and N. J. White are at the Wellcome Trust–Mahosot Hospital–Oxford Tropical Medicine Research Collaboration, Mahosot Hospital, Vientiane, Lao PDR. R. McGready, S. Proux, and F. Nosten are at the Shoklo Malaria Research Unit, Mae Sot, Tak Province, Thailand. R. McGready, S. Proux, P. Singhasivanon, N. P. J. Day, F. Nosten, and N. J. White are at the Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. F. Fernandez is at the School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, United States of America. M. D. Green is at the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America. M. Sunjio and P. Millet are at EA3677 Bases Thérapeutiques des Inflammations et des Infections, Université Victor Segalen, Bordeaux, France. C. Bruneton is at Réseau Médicaments et Développement, Paris, France. S. Phanouvong is at the Drug Quality and Information Program, Global Assistance Initiatives, United States Pharmacopeia, Rockville, Maryland, United States of America. C. J. M. Whitty, H. Kaur, and B. M. Greenwood are at the Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom. A. O. Talisuna is at the East African Network for Monitoring Antimalarial Treatment, and Ministry of Health, Uganda. E. M. Christophel and K. Palmer are at the Western Pacific Regional Office of the World Health Organization, Manila, Philippines. G. Malenga is at the Malaria Alert Centre, Bantyre, Malawi. K. Bojang is at the MRC Laboratories, Fajara, Banjul, The Gambia

                * To whom correspondence should be addressed: E-mail: paul@ 123456tropmedres.ac
                Article
                DOI: 10.1371/journal.pmed.0030197
                PMC ID: 1475657
                PubMed ID: 16752952
                SO-VID: dbf0d4a4-da6c-4a4a-8cfe-6874977cd716
                Copyright © Copyright: © 2006 Newton et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Categories
                Subject: Policy Forum
                Subject: Infectious Diseases
                Subject: Microbiology
                Subject: Other
                Subject: Clinical Pharmacology
                Subject: Epidemiology/Public Health
                Subject: Health Economics
                Subject: Health Policy
                Subject: Pediatrics
                Subject: Malaria
                Subject: Infectious Diseases
                Subject: Regulation
                Subject: Drugs and Adverse Drug Reactions
                Subject: Medicine in Developing Countries

                ScienceOpen disciplines: Medicine
                Data availability:
                ScienceOpen disciplines: Medicine

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