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Mavungu Landu DJ, Frédérich M, Manzambi Kuwekita J, Bongo-Pasi Nswe C, Mbinze JK, Liégeois S, Kalenda Tshilombo N, Kwete Minga M, Ciza Hamuli P, Hubert P, Marini Djang'eing'a R. Quality of antimalarials in Kinshasa peri-urban areas with regard to local pharmaceutical legislation and regulation. Int Health 2020; 12:253-263. [PMID: 31613326 PMCID: PMC7322209 DOI: 10.1093/inthealth/ihz070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/09/2019] [Accepted: 07/12/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the context of old pharmaceutical legislation and regulations not adapted to current realities, the aim of the present study was to evaluate the existing pharmaceutical system in peri-urban areas of Kinshasa. METHODS A prospective study was carried out during the period 2016-2018. The most used antimalarial medicines were identified through household and pharmaceutical establishment surveys. The samples of the obtained medicines were assayed with generic separation methods using the high-performance liquid chromatography technique coupled to a diode array detector. The registration status was checked for 126 antimalarial brand names. A characterization was carried out in 196 pharmaceutical establishments on the basis of standards set out by the Ministry of Health. RESULTS Of the 75 samples assayed, 19% (14/75) were non-compliant. Of the 124 brand names, 46.0% (57/124) were unlicensed and 14.5% (18/124) had an expired licence. Of the 196 pharmaceutical establishments, only 2 (1.0%) had an authorization to practice, none met all the Ministry of Health minimum standards and 24.5% (48/196) met the World Health Organization Guidelines for the Storage of Essential Medicines and Other Health Commodities. CONCLUSIONS More resources should be mobilized to apply regulator sanctions.
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Affiliation(s)
- Don Jethro Mavungu Landu
- Laboratory of Pharmacognosy, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium.,Ecole Régionale Postuniversitaire d'Aménagement et de Gestion intégrée des Forêts et Territoires tropicaux, University of Kinshasa, Kinshasa 10, Democratic Republic of Congo
| | - Michel Frédérich
- Laboratory of Pharmacognosy, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium
| | - Joseph Manzambi Kuwekita
- Department of Public Health Sciences, Liège University, Liège 4000, Belgium.,Community Health Section, Institut Supérieur des Techniques Médicales de Kinshasa, Kinshasa 10, Democratic Republic of Congo
| | - Christian Bongo-Pasi Nswe
- Faculty of Public Health, Université des Sciences et des Technologies de Lodja, Sankuru 83, Democratic Republic of Congo
| | - J K Mbinze
- Laboratory of Drug Analysis, Department of Galenic Pharmacy and Drug Analysis, University of Kinshasa, Kinshasa 10, Democratic Republic of Congo
| | - Sophie Liégeois
- Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium
| | - Nicodème Kalenda Tshilombo
- Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium.,Laboratory of Chromatography, Faculty of Pharmaceutical Sciences, University of Kinshasa, Kinshasa 10, Democratic Republic of Congo
| | - Mineze Kwete Minga
- Advanced School of Translation and Interpretation, Université Pédagogique Nationale, Kinshasa 10, Democratic Republic of Congo
| | - Patient Ciza Hamuli
- Laboratory of Drug Analysis, Department of Galenic Pharmacy and Drug Analysis, University of Kinshasa, Kinshasa 10, Democratic Republic of Congo.,Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium
| | - Philippe Hubert
- Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium
| | - Roland Marini Djang'eing'a
- Laboratory of Analytical Pharmaceutical Chemistry, CIRM, Department of Pharmacy, Liège University, Liège 4000, Belgium
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Aydemir O, Janko M, Hathaway NJ, Verity R, Mwandagalirwa MK, Tshefu AK, Tessema SK, Marsh PW, Tran A, Reimonn T, Ghani AC, Ghansah A, Juliano JJ, Greenhouse BR, Emch M, Meshnick SR, Bailey JA. Drug-Resistance and Population Structure of Plasmodium falciparum Across the Democratic Republic of Congo Using High-Throughput Molecular Inversion Probes. J Infect Dis 2018; 218:946-955. [PMID: 29718283 PMCID: PMC6093412 DOI: 10.1093/infdis/jiy223] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/26/2018] [Indexed: 11/21/2022] Open
Abstract
A better understanding of the drivers of the spread of malaria parasites and drug resistance across space and time is needed. These drivers can be elucidated using genetic tools. Here, a novel molecular inversion probe (MIP) panel targeting all major drug-resistance mutations and a set of microsatellites was used to genotype Plasmodium falciparum infections of 552 children from the 2013-2014 Demographic and Health Survey conducted in the Democratic Republic of the Congo (DRC). Microsatellite-based analysis of population structure suggests that parasites within the DRC form a homogeneous population. In contrast, sulfadoxine-resistance markers in dihydropteroate synthase show marked spatial structure with ongoing spread of double and triple mutants compared with 2007. These findings suggest that parasites in the DRC remain panmictic despite rapidly spreading antimalarial-resistance mutations. Moreover, highly multiplexed targeted sequencing using MIPs emerges as a cost-effective method for elucidating pathogen genetics in complex infections in large cohorts.
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Affiliation(s)
- Ozkan Aydemir
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
| | - Mark Janko
- Department of Geography, University of North Carolina, Chapel Hill
| | - Nick J Hathaway
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
| | - Robert Verity
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom
| | | | - Antoinette K Tshefu
- Community Health, Kinshasa School of Public Health, School of Medicine, University of Kinshasa, Democratic Republic of Congo
| | | | - Patrick W Marsh
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
| | - Alice Tran
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
| | - Thomas Reimonn
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
| | - Azra C Ghani
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, United Kingdom
| | - Anita Ghansah
- Department of Parasitology, Noguchi Memorial Institute of Medical Research, Ghana
| | - Jonathan J Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
- Division of Infectious Diseases, University of North Carolina, Chapel Hill
- Curriculum in Genetics and Microbiology, University of North Carolina, Chapel Hill
| | | | - Michael Emch
- Department of Geography, University of North Carolina, Chapel Hill
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
| | - Steven R Meshnick
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill
- Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina, Chapel Hill
| | - Jeffrey A Bailey
- Program in Bioinformatics and Integrative Biology, University of Massachusetts, Worcester
- Division of Transfusion Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester
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Nkoli Mandoko P, Rouvier F, Matendo Kakina L, Moke Mbongi D, Latour C, Losimba Likwela J, Ngoyi Mumba D, Bi Shamamba SK, Tamfum Muyembe JJ, Muepu Tshilolo L, Parzy D, Sinou V. Prevalence of Plasmodium falciparum parasites resistant to sulfadoxine/pyrimethamine in the Democratic Republic of the Congo: emergence of highly resistant pfdhfr/pfdhps alleles. J Antimicrob Chemother 2018; 73:2704-2715. [DOI: 10.1093/jac/dky258] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/06/2018] [Indexed: 01/06/2023] Open
Affiliation(s)
- Papy Nkoli Mandoko
- National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Florent Rouvier
- Department of Biology, K-Plan, Grand Luminy Technopôle, Marseille, France
| | - Lebon Matendo Kakina
- National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | - Destin Moke Mbongi
- Centre de Formation et d’Appui Sanitaire (CEFA)/Centre Hospitalier Monkole, Kinshasa, Democratic Republic of the Congo
| | - Christine Latour
- Department of Biology, K-Plan, Grand Luminy Technopôle, Marseille, France
| | - Joris Losimba Likwela
- Department of Public Health, Faculty of Medicine and Pharmacy, University of Kisangani, Kisangani, Democratic Republic of the Congo
- National Malaria Control Program, Kinshasa, Democratic Republic of the Congo
| | - Dieudonné Ngoyi Mumba
- National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo
| | | | | | - Léon Muepu Tshilolo
- Centre de Formation et d’Appui Sanitaire (CEFA)/Centre Hospitalier Monkole, Kinshasa, Democratic Republic of the Congo
| | - Daniel Parzy
- Department of Biology, K-Plan, Grand Luminy Technopôle, Marseille, France
| | - Véronique Sinou
- UMR-MD3, University of Aix-Marseille, Faculty of Pharmacy, Marseille, France
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