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The Antimalarial Drug Policy in the Republic of Yemen

. . The results of the previous studies, conducted mainly in the eighties, were reviewed. . . . . . . . . . . . . . Sana'a Inter-Country Meeting in April 2002On Monitoring the Efficacy of AMDs . . Following the inter-country workshop on monitoring the efficacy of AMDs in Sheraton Sana'a in 2002, a national team (core group) was formed from the NMCP, the faculties of medicine and pharmacy and the WHO consultants..

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The Antimalarial Drug Policy in the Republic of Yemen

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    1. The Antimalarial Drug Policy in the Republic of Yemen Meeting For Discussions Towards The Development Of An Interregional Network For Monitoring Antimalarial Drug Efficacy In The Horn Of Africa 23-25 March 2004

    3. The results of the previous studies, conducted mainly in the eighties, were reviewed

    10. Sana’a Inter-Country Meeting in April 2002 On Monitoring the Efficacy of AMDs

    11. Following the inter-country workshop on monitoring the efficacy of AMDs in Sheraton Sana’a in 2002, a national team (core group) was formed from the NMCP, the faculties of medicine and pharmacy and the WHO consultants.

    12. Establishing sentinel sites representing the different epidemiological strata in Yemen

    13. The following sites were initiated starting from 2002: 1- Bajil in Hodeida governorate in 2002 2- W. Mesemeer in Lahj governorate in 2002 3- Al Odein in Ibb governorate in 2003

    14. The following sites are planned to be established in 2004: 1- Harad in Hajja governorate 2- Broom in Hadramawt governorate 3- Al Madarba in Lahj governorate

    15. Chloroquine was studied in the following sites: 1- Bajil in 2002 2- Wadi Al Mesemeer in 2002 3- Al Odein in 2003

    16. Sulfadoxine/Pyrimethamine (Fansidar) is being studied currently in Harad starting from February 2004

    24. An Assessment Of The Quality Of The Most Widely Used Anti-malarial Drugs (AMDs) In Yemen: A study conducted by Dr Ahmed Abdo-Rabbo, Associate Professor in Pharmacotherapy, Faculty of Medicine & Health Sciences in Sana’a University

    25. CONCLUSIONS: 1- There is a problem of substandard AMD products in different districts and at different levels of the distribution chain: samples below the lower limit of specification few “high” failures of active ingredient contents of CQ syrup and CQ tablets low failures for CQ tablets and S/P tablets dissolution

    26. failures were found amongst locally made as well as foreign products 2- Percentage failure of samples based on ingredient content and dissolution failures cannot be ignored. 3- Poor quality of AMDs will result in ineffective treatment, health risks such as discomfort to the patient, exacerbation or prolongation of illness, admission to hospital, development or resistance and needless expenditure.

    27. RECOMMENDATIONS: 1- Promoting good procurement practices in the public sector by prequalification of suppliers, I.e, purchasing from reliable and approved sources and good quality suppliers.

    28. 2- The pharmaceutical companies from which drugs are imported should be registered and AMDs should be subjected to QC before registration. 3- Specification at the time of tendering should include an adequate shelf-life, and detailed packing requirements and special labeling as relevant.

    29. 4- Although the cost of AMDs is important, good quality AMDs are more important than cheaper and poor drugs. 5- Testing for initial quality should be given high priority. Routine testing of new supplies is recommended, even if the manufacturer has a proven good record.

    30. 6- Monitoring the manufacturer’s and supplier’s good manufacturer compliance (GMC) is important. 7- AMDs should be stored and distributed at appropriate conditions in harbour, stores and health facilities as well as at the level of the end users.

    31. 8- Measures should be taken to stop illegal importing or smuggling of AMDs. 9- Proper training of pharmacists and assistant pharmacists and all those involved in drug supply management and QC

    32. STUDY BY DR REEM MUBAJER FACULTY OF MEDICINE ADEN UNIVERSITY Ph.D Student in LSTM, UK TDR Grant/WHO/EMRO

    33. Objectives: 1- To determine the prevalence of CQ resistance in Pf by in-vivo testing 2- To study the susceptibility of Pf to CQ, MQ, Amodiaquine, Qn, S/P, Artemisinine by in-vitro testing 3- To assess the performance of molecular markers for mutations in pfcrt, pfmdr1 and Pfcrg in identifying CQ resistance in Yemen

    34. 4- To correlate the results of in-vivo and in-vitro tests with the PCR results for point mutation 5- To study the association of some easily identifiable risk factors with CQ treatment failure

    35. IN-VITRO STUDY IN 2003 (Bajil district, Hodeida governorate) By Mr Abdul Illah Al Harazi Head of Laboratory in the Yemeni German Hospital in Sana’a

    39. Future Plans In 2004 1- AMDs planned to be monitored in 2004 S/P (Fansidar) AQ (Amodiaquine) ART + S/P (Artesunate + Fansidar) ART +AQ (Artesunate + Amodiaquine) AM / LUM (Artemether + Lumefantrine) Q (Quinine)

    40. 2- Involving the private sector in monitoring the efficacy of AMDs

    41. 3- Evaluation of the results and review of the national AMD policy by the Core Group (NMCP, Faculties of medicine and pharmacy in Sana’a & Aden universities, WHO) in the 2nd half of 2004

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