Quality of Commercial Alcohol-based Hand Sanitizers in Kampala: a Non-addressed Issue in Covid-19 Prevention in Uganda

Abstract

Introduction: The identification and worldwide spread of the new coronavirus disease 2019 (COVID-19) is a global public health emergency. The World Health Organization recommended alcohol-based hand sanitizers to prevent human-to-human transmission of coronavirus. The quality of hand sanitizers is of global concern. Objective: This study aimed to conduct a qualitative and quantitative evaluation of commercial alcohol-based hand sanitizers in Kampala, Uganda. Methods: Commercial products (130) in the market were sampled from five Divisions of Kampala city. The samples were assessed for appearance, packaging, labelling, and quality mark conformity. In addition, the pH of the samples was measured. Gas chromatography coupled with mass spectrometry and with flame ionization detectors were used for qualitative and quantitative analysis of the alcohol-based hand sanitizers, respectively. Results and Discussion: Only 15 samples (12%) met all the specifications for appearance, packaging, labelling, and regulation characteristics assessed. Alcohol was detected in 128 samples (98%). The specific alcohols detected were as follows: Ethanol (86%), isopropyl alcohol (4%), and ethanol/isopropyl alcohol admixture (3%). Two samples contained no alcohol. Isopropyl alcohol was found as a denaturant in only one sample contrary to the label claims in seven samples. Seven samples contained methanol as an impurity. Twenty-two samples had divergent alcohol types from those declared on the label. Seventy-eight samples had alcohol content within the requisite range of 60-95% v/v. Forty-two had less than 60% v/v alcohol, and one contained more than 95% v/v. Five samples indicated methanol substitution, containing methanol solely, and two methanol contamination with methanol content above limits. A majority of the alcohol concentrations found in the study did not agree with the concentrations indicated on the labels. Sixty-seven samples did not comply with the specifications for pH. Conclusion: Substandard and falsified alcohol-based hand sanitizers that contain harmful ingredients such as methanol are in circulation in the Kampala City Divisions. Recommendation: There is a need to strengthen the regulatory institution and improve surveillance mechanisms to ensure compliance with set standards in manufacturing alcohol-based hand sanitizers in Uganda.