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. 2013;8(3):e58303.
doi: 10.1371/journal.pone.0058303. Epub 2013 Mar 6.

Children's medicines in Tanzania: a national survey of administration practices and preferences

Lisa V Adams  1 , Sienna R Craig, Elia John Mmbaga, Helga Naburi, Timothy Lahey, Cameron T Nutt, Rodrick Kisenge, Gary J Noel, Stephen P Spielberg
Affiliations

Children's medicines in Tanzania: a national survey of administration practices and preferences

Lisa V Adams et al. PLoS One. 2013.

Abstract

Objective: The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics.

Patients and methods: We surveyed children aged 6-12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre.

Results: Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take.

Conclusions: There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings.

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Conflict of interest statement

Competing Interests: Dr. GN participated in the data analysis and manuscript preparation on behalf of the Institute for Pediatric Innovation (IPI). All work he completed on this project predated his current employment at AstraZeneca. The authors declare that his current relationship with AstraZeneca or past relationship with IPI does not impact or alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials.

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