Insights Into the Availability and Distribution of Oral Artemisinin Monotherapy in Myanmar: Evidence From a Nationally Representative Outlet Survey.

Authors

Kathryn A. O'Connell, ACTwatch Group
Vamsi Vasireddy, ACTwatch Group
Megan Littrell, ACTwatch GroupFollow
Andria Rusk, ACTwatch GroupFollow
ACTwatch Group
Si Thu Thein, Population Services International Myanmar, Yangon, MyanmarFollow
Hnin Su Su Khin, Population Services International Myanmar, Yangon, MyanmarFollow
Aung Thi, National Malaria Control Programme, Department of Public Health, Ministry of Health and Sports, Nay Pyi Taw, MyanmarFollow

Document Type

Article

Source

Malaria Journal

ISSN

1475-2875

Volume

16

Issue

1

First Page

170

Last Page

170

Publication Date

4-25-2017

Department

Public Health

Abstract

BACKGROUND: The containment of artemisinin resistance in Myanmar, historically an important probable origin and route of anti-malarial resistance to the India sub-continent and beyond, is crucial to global malaria control and elimination. This paper describes what is currently known about the sale and distribution of oral artemisinin monotherapy (AMT) across Myanmar, where this medicine is commonly found.

METHODS: A nationally representative 2015 outlet survey was conducted in the private sector, and among community health workers across four geographical domains. A national sample of outlets was screened for availability of malaria testing and treatment, and an audit was completed for all anti-malarials.

RESULTS: A total of 3859 outlets across Myanmar had an anti-malarial in stock on the day of survey. Of the 3859 anti-malarial stocking outlets, 988 outlets stocked oral AMT. Availability of oral AMT was highest among outlets in the Western border (36.8%) versus other domains (Eastern, 15.0%; Central, 19.3% Coastal, 10.7%). Over 90% of the oral AMT service delivery points were private sector outlets: general retailers (49.4%), pharmacies (23.5%), and itinerant drug vendors (14.2%). Eleven unique oral AMT products were audited. The most common product audited was Artesunate

CONCLUSIONS: Given the high availability and distribution of oral AMT, it is possible that Myanmar has become the last remaining viable market for any oral AMT in the region for manufacturers. National and international organizations need to act quickly and effectively to stop the production and distribution to both improve malaria control within Myanmar and reduce risk of artemisinin resistance spreading to India and Africa.

Comments

Dr. Megan Littrell (Principal Investigator, 2014-2017); Dr. Kathryn A. O’Connell (Principal Investigator, 2008-2012); Dr. Vamsi Vasireddy (Principal Investigator, 2013)

Rights

Copyright © The Author(s), 2017

PubMed ID

28438145

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.