Abstract

On the Hunt for Sub-standard Antibiotics in Africa with Paper-based Analytical Devices

Marya Lieberman, Professor, University Of Notre Dame

Every antibiotic has an allowed variation of the quantity of active pharmaceutical ingredients (APIs), generally running from 90%-120% of the stated API content.  Products which fall outside of these quality standards can harm patients and contribute to development of drug-resistant pathogens, so there is a public health imperative to find them and get them out of the market.  However, quantitative analysis of medicines in low resource settings is difficult.  Most countries in Africa don't have a WHO-prequalified pharmaceutical analysis lab.  Others have such a lab, but lack capacity for the broad market sampling necessary to detect poor quality products.  Paper diagnostic devices could help to fill this gap in analytical capacity.  We are working with pharmacists in Kenya and Malawi using paper test cards and a neural network image analysis program to detect falsified and degraded products.  However, these cards could not directly quantify active ingredient content, so they could not directly detect substandard products.  We recently designed a new paper test card to quantify the content of beta lactam antibiotics in pills.  I'll describe the chemistry in detail and  discuss how we are implementing these paper analytical devices in a field setting to replace HPLC analysis.  We are also exploring local manufacture of the paper test cards in Kenya.