By Gatonye Gathura
More than a third of epilepsy medicines in Kenya are of poor quality; reveals a survey in three African countries.
Most of the poor quality medicines, the study shows are imported from China followed by those manufactured in India
The study by the Kenyan Medical Research Institute (Kemri) and the University of Limoges, France, analysed the quality of epilepsy drugs in Kenya, Madagascar and Gabon
Over all, the report published on last week in the journal Epilepsia, found about 32 per cent of the anti-epilepsy tablets in the three countries to be of poor quality.
In Kenya 37 per cent of the medicines were of low quality, 34 per cent in Madagascar and 26 per cent in Gabon.
The study which in Kenya covered Kilifi and Mombasa also involved researchers from the Oxford University, UK, and Paris Descartes University, France.
The researchers had collected 3,782 tablets and capsules from public, private and informal pharmaceutical outlets such as shops, kiosks and streets from the three countries and shipped them to France for testing.
The medicines were tested for uniformity, dissolution, disintegration, friability, chemical stability, impurities, content, packaging and patient information.
Epilepsy drugs in the public facilities in Kenya were more likely to be of low quality than those in the private sector.
“A poor quality anti-epilepsy drug is almost worse than the non-availability of good medicines,” says Dr Jeremy Jost, the lead author.
Long-term exposure to poor-quality epilepsy drugs, Dr Jost explained may result in a lack of confidence in formal medicines pushing patients to alternative and unproven treatments.
The researchers found anti-epilepsy drugs manufactured in Africa to be of much better quality than those from China and India.
Ninety per cent of the good quality anti-epilepsy drugs were those manufactured in Kenya, Senegal and Madagascar, much higher than those from Europe.
Good quality drugs imported from the European Union represented about 65 per cent, 38 per cent from India and 23 per cent from China.
“These results support the local production of anti-epilepsy medicines and dispels locally held beliefs that drugs manufactured in the Europe are necessarily of higher quality,” says the new study.
The study had tested a wide range of anti-epilepsy drugs including carbamazepine, phenytoin, sodium valproate, phenobarbital and diazepam all failing tests at different levels.
But even where drugs were of good quality the study found poor storage and distribution practices to compromise quality.
This was especially aggravated by lack of temperature and humidity controls in most of the drug distribution points.
This, study co-author Dr Symon Kariuki of Kemri says is likely to led to drug deterioration especially in an environment like Mombasa with high humidity and temperatures.
It was also observed that in Kenya, retailers are likely to unpack the medicines and sell in small units.
The practice off unpacking, the experts say is likely to expose the products to further deterioration.
The researchers also observed poor packaging standards especially in Kenya.
“All the samples collected from Kenya were sold without secondary packaging while 22 per cent were without any packaging,” says Dr Kariuki.
Poor storage, the authors say, without temperature and humidity control and unpacking practices generate poor quality and possibly dangerous drugs.
The Kenya National Guidelines for the Management of Epilepsy 2016 describes epilepsy as a chronic brain disorder characterized by repetitive unprovoked seizures more than two times 24 hours apart in a year.
It is estimated that the disease affects more than 70 million people worldwide. In Kenya, it is estimated that around 800,000 to one million people are living with epilepsy.
Of this, only about 10 per cent are on treatment with the gap linked to lack of available, accessible and affordable health care and lack of awareness.
32 per cent of anti-epilepsy medicines in Kenya, Madagascar, Gabon of poor quality
37 per cent of the drugs in Kenya of poor quality
Drugs collected at the Coast and tested in France
Medicines from China, India of lowest quality
Comparatively local drugs of high quality
Most of poor quality drugs in the public sector
Most of the drugs packed and stored in poor conditions
There are about 70 million epileptics globally
In Kenya, there are about one million epileptics
Only 10 per cent in Kenya are on treatment