Travel and fake artesunate: a risky business

In October, 2011, a previously well 28-year-old woman from Spain was admitted to our hospital with a 5 day history of fever, rigors, headache, back pain, and myalgia. She was a regular traveller to Equatorial Guinea and usually took no chemoprophylaxis. She had acquired malaria on three previous occasions all of which resolved with a 3 day course of locally acquired artesunate monotherapy combined with another antimalarial drug.

On this occasion, after a 1 month visit, she was diagnosed at a local health centre with slide-positive falciparum malaria and instructed to buy artesunate monotherapy and sulfadoxine-pyrimethamine from the local traders in Bata. She bought two boxes of Artesunat® 50 mg labelled as manufactured by Mekophar, Vietnam, and started taking four tablets a day together with sulfadoxine-pyrimethamine. After 3 days, her symptoms persisted and she decided to return home.

CITATION  Lancet. 2012 Sep 22;380(9847):1120. doi: 10.1016/S0140-6736(12)60649-7