Abstract:
The objective of this work was to develop high performance liquid chromatographic
(HPLC) methods and apply them in assessing the pattern and extent of antimalarial
drug utilization and their quality in Tanzania. The drugs investigated were
amodiaquine, chloroquine and sulfadoxine/pyrimethamine.
Pyrimethamine and chloroquine filter paper methods and another HPLC method for
measuring amodiaquine in human biological fluids were developed at Karolinska
Institute (Kl), in Sweden and were applied at MUCHS to carry out a quality
assessment of antimalarials collected from wholesale importers in Dar Es Salaam and
to investigate diffusion of new malaria treatment policy in a rural community in
Tanzania.
The collected brands of sulfadoxine/pyrimethamine and amodiaquine tablet
formulations were tested for content of active components and dissolution
characteristics. Comparison of bioavailability of two SP formulations was conducted
using healthy volunteers. Blood samples (100 Ill) were collected and assayed for
levels of sulfadoxine and pyrimethamine using HPLC methods.
In households at Kibaha district, mothers with children underfive years of age were
interviewed on treatment practices of malaria. Capillary blood was collected on filter
paper in duplicate from one underfive in all the households with children. The
samples were assayed for chloroquine and sulfadoxine/pyrimethamine using HPLC
methods. Drug levels were used to assess drug pressure and extent of diffusion of the
new malaria policy in the area.
The developed analytical methods are capable of applying small volumes of blood
making them suitable for field studies, in resource limited settings. By applying these
analytical methods, it was possible to confirm dissolution failure rates of 13% and
44% of the collected AQ and SP samples respectively. By combining mothers'
interviews and drug level analysis, it was possible to confirm that the new malaria
treatment policy had diffused and there was low SP overprescribing at Kibaha
district.
It can be concluded that HPLC methods applying small volume of blood samples
especially dried samples on filter paper are useful tool in epidemiological studies as
well as phannacokinetic studies in resource constrained analytical laboratories of
developing countries.
