Table 4

Risk factors associated with substandard (n=11) and falsified (n=50) ACAs (n=677)

Sample characteristics of ACAsTotal number of samplesPoor-quality samplesCrude ORs
(95% CI)
Likelihood- ratio p value
Generic typeAM35034 (9.7%)10.36
DHA31 (33.3%)4.6 (0.4 to 52.6)
AS32426 (8.0%)0.8 (0.5 to 1.4)
WHO prequalified/AQACTNot prequalified37935 (9.2%)10.82
Prequalified29826 (8.7%)0.9 (0.6 to 1.6)
AMFmNon-AMFm medicines57936 (6.2%)1<0.001
AMFm medicines9825 (25.5%)5.2 (2.9 to 9.1)
Region of stated country of manufactureAsia47133 (7.0%)1<0.001
North America7126 (36.6%)7.7 (4.2 to 14.0)
Not stated732 (2.7%)0.4 (0.1 to 1.6)
Expired at time of analysisNot expired66356 (8.4%)1<0.001
Expired*145 (35.7%)6.0 (2.1 to 17.0)
Outlet typePharmacies51951 (9.8%)10.14
Medicine vendors755 (6.7%)0.7 (0.3 to 1.7)
Private clinics895 (5.6%)0.5 (0.2 to 1.4)
  • *Of the five expired samples, one was a falsified tablet and four were substandard suspensions.

  • ACAs, artemisinin-containing antimalarials; AM, artemether; AMFm, Affordable Medicines Facility—malaria; AQACT, acceptable quality-artemisinin combination therapy; AS, artesunate; DHA, dihydroartemisinin; ORs, odds ratio.