Description of all samples purchased using three sampling approaches (convenience-mystery client, island-wide survey-mystery client and randomised-overt survey) on Bioko Island, Equatorial Guinea; n=677
| Variable | Convenience-mystery client | Island-wide survey-mystery client | Randomised-overt survey | |||||||||
| Pharm | MVs | PCs | Total | Pharm | MVs | PCs | Total | Pharm | MVs | PCs | Total | |
| Artemisinin combination therapies | ||||||||||||
| AM-LUM | 10 (90.9%) | 3 (50.0%) | 0 | 13 (76.5%) | 104 (73.8%) | 9 (81.8%) | 11 (25.0%) | 124 (63.3%) | 92 (77.3%) | 2 (100.0%) | 9 (81.8%) | 103 (78.0%) |
| AS-ADQ | 1 (9.1%) | 2 (33.3%) | 0 | 3 (17.6%) | 22 (15.6%) | 2 (18.2%) | 33 (75.0%) | 57 (29.1%) | 15 (12.6%) | 0 | 2 (18.2%) | 17 (12.9%) |
| AS-MEF | 0 | 0 | 0 | 0 | 1 (0.7%) | 0 | 0 | 1 (0.5%) | 0 | 0 | 0 | 0 |
| AS-SULFMEX-PYR | 0 | 1 (16.7%) | 0 | 1 (5.9%) | 12 (8.5%) | 0 | 0 | 12 (6.1%) | 11 (9.2%) | 0 | 0 | 11 (8.3%) |
| DHA-PIP | 0 | 0 | 0 | 0 | 2 (1.4%) | 0 | 0 | 2 (1.0%) | 1 (0.9%) | 0 | 0 | 1 (0.8%) |
| Total | 11 | 6 | 0 | 17 | 141 | 11 | 44 | 196 | 119 | 2 | 11 | 132 |
| All monotherapies (suspensions, n=7; injections, n=129; capsules, n=1 and tablets, n=195) | ||||||||||||
| AM | 0 | 0 | 0 | 0 | 30 (25.4%) | 13 (30.2%) | 1 (9.1%) | 44 (25.6%) | 54 (46.2%) | 2 (33.3%) | 10 (43.5%) | 66 (45.2%) |
| AS | 10 (100.0%) | 0 | 4 (100.0%) | 14 (100.0%) | 88 (74.6%) | 30 (69.8%) | 10 (90.9%) | 128 (74.4%) | 63 (53.8%) | 4 (66.7%) | 13 (56.5%) | 80 (54.8%) |
| Total | 10 | 0 | 4 | 14 | 118 | 43 | 11 | 172 | 117 | 6 | 23 | 146 |
| Monotherapy blister packed tablets (n=195) | ||||||||||||
| AS | 10 (100.0%) | 0 | 4 (100.0%) | 14* (100.0%) | 84 (100.0%) | 26 (100.0%) | 10 (100.0%) | 120** (100.0%) | 50 (100.0%) | 2 (100.0%) | 9 (100.0%) | 61*,** (100.0%) |
| Dose form | ||||||||||||
| Tablets | 21 (100.0%) | 10 (100.0%) | 0 | 31 (100.0%) | 217 (83.8%) | 36 (66.7%) | 52 (94.6%) | 305 (82.9%) | 143 (60.6%) | 2 (25.0%) | 13 (38.2%) | 158 (56.8%) |
| Capsules | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 (0.4%) | 0 | 0 | 1 (0.4%) |
| Suspensions | 0 | 0 | 0 | 0 | 8 (3.1%) | 1 (1.9%) | 2 (3.6%) | 11 (3.0%) | 31 (13.2%) | 3 (37.5%) | 7 (20.6%) | 41 (14.7%) |
| Injections | 0 | 0 | 0 | 0 | 34 (13.1%) | 17 (31.4) | 1 (1.8%) | 52 (14.1%) | 60 (25.4%) | 3 (37.5%) | 14 (41.2%) | 77 (27.7%) |
| Granules/powders | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 (0.4%) | 0 | 0 | 1 (0.4%) |
| Total | 21 | 10 | 0 | 31 | 259 | 54 | 55 | 368 | 236 | 8 | 34 | 278 |
| WHO prequalification | ||||||||||||
| Not WHO prequalified | 9 (42.9%) | 5 (50.0%) | 0 | 14 (45.2%) | 142 (54.8%) | 32 (59.3%) | 7 (12.7%) | 181 (49.2%) | 156 (66.1%) | 6 (75.0%) | 22 (64.7%) | 184 (66.2%) |
| WHO prequalified | 12 (57.1%) | 5 (50.0%) | 0 | 17 (54.8%) | 117 (45.2%) | 22 (40.7%) | 48 (87.3%) | 187 (50.8%) | 80 (33.9%) | 2 (25.0%) | 12 (35.3%) | 94 (33.8%) |
| Total | 21 | 10 | 0 | 31 | 259 | 54 | 55 | 368 | 236 | 8 | 34 | 278 |
| Stated region of manufacture | ||||||||||||
| Africa | 0 | 0 | 0 | 0 | 8 (3.1%) | 0 | 32 (58.2%) | 40 (10.9%) | 9 (3.8%) | 0 | 0 | 9 (3.2%) |
| Asia | 16 (76.2%) | 8 (80.0%) | 0 | 24 (77.4%) | 193 (74.5%) | 45 (83.3%) | 17 (30.9%) | 255 (69.3%) | 163 (69.1%) | 7 (70.0%) | 29 (90.6%) | 199 (71.6%) |
| Europe | 0 | 1 (10.0%) | 0 | 1 (3.2%) | 19 (7.3%) | 1 (1.9%) | 2 (3.6%) | 22 (6.0%) | 28 (11.9%) | 1 (10.0%) | 3 (9.4%) | 32 (11.5%) |
| North America | 5 (23.8%) | 1 (10.0%) | 0 | 6 (19.4%) | 35 (13.5%) | 4 (7.4%) | 4 (7.3%) | 43 (11.7%) | 22 (9.3%) | 0 | 0 | 22 (7.9%) |
| Not stated | 0 | 0 | 0 | 0 | 4 (1.6%) | 4 (7.4%) | 0 | 8 (2.1%) | 14 (5.9%) | 2 (20.0%) | 0 | 16 (5.8%) |
| Total | 21 | 10 | 0 | 31 | 259 | 54 | 55 | 368 | 236 | 10 | 32 | 278 |
Significant difference between the proportion of monotherapy (AS) tablets purchased using the three sampling approaches was as follows:
*p=0.004: between convenience-mystery client (45.2%) and randomised-overt survey (21.9%).
**p=0.003: between island-wide survey-mystery client (32.6%) and randomised-overt survey (21.9%).
No significant difference between convenience-mystery client and island-wide survey-mystery clients.
ADQ, amodiaquine; AM, artemether; ART, artemisinin; AS, artesunate; DHA, dihydroartemisinin; LUM, lumefantrine; MEF, mefloquine; MVs, medicine vendors; PCs, private clinics; Pharm, pharmacies; PIP, piperaquine; PYR, pyrimethamine; SULDOX, sulfadoxine; SULFMEX, sulfamethoxypyridazine.