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There is an urgent need for accurate and inexpensive handheld instruments for the evaluation of medicine quality in the field. A blinded evaluation of the diagnostic accuracy of the Counterfeit Detection Device 3 (CD-3), developed by the US Food and Drug Administration Forensic Chemistry Center, was conducted in the Lao People's Democratic Republic. Two hundred three samples of the oral antimalarial artesunate were compared with authentic products using the CD-3 by a trainer and two trainees. The specificity (95% confidence interval [95% CI]), sensitivity (95% CI), positive predictive value (95% CI), and negative predictive value (95% CI) of the CD-3 for detecting counterfeit (falsified) artesunate were 100% (93.8-100%), 98.4% (93.8-99.7%), 100% (96.2-100%), and 97.4% (90.2-99.6%), respectively. Interobserver agreement for 203 samples of artesunate was 100%. The CD-3 holds promise as a relatively inexpensive and easy to use instrument for field evaluation of medicines, potentially empowering drug inspectors, customs agents, and pharmacists.

Original publication

DOI

10.4269/ajtmh.13-0644

Type

Journal article

Journal

Am J Trop Med Hyg

Publication Date

11/2014

Volume

91

Pages

920 - 924

Keywords

Antimalarials, Artemisinins, Artesunate, Chromatography, High Pressure Liquid, Confidence Intervals, Counterfeit Drugs, Fluorescence, Laos, Malaria, Optical Imaging, Sensitivity and Specificity