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RESULTS

T ablets are more acceptable and give fewer problems than syrups among young HIV-infected children in resource-limited settings in the ARROW trial. Patricia Nahirya Ntege on behalf of the ARROW trial team.

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RESULTS

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  1. Tablets are more acceptable and give fewer problems than syrups among young HIV-infected children in resource-limited settings in the ARROW trial.Patricia Nahirya Ntege on behalf of the ARROW trial team • The provision of anti-retrovirals (ARVs) for children is complicated by syrup formulations which in comparison to tablets are: • more expensive • harder to transport and store • difficult for carers to administer • ARROW is an ongoing randomised trial of paediatric ARV monitoring and treatment strategies • 1207 children aged 3 months to 17 years enrolled in Uganda/Zimbabwe during 2007/08. • We explored the acceptability of syrup and scored tablet ARVs dosed according to WHO weight bands among children substituting syrups with tablets • Questionnaires were administered to elicit carer and child’s expected (baseline) and experienced (8 weeks later) use of scored tablets after changing from syrups

  2. RESULTS At enrolment 34%(406/1207)childrenreceived syrups of individual drugs (NNRTI + 2 or 3 of ZDV, ABC, 3TC) 58% (236/406 ) children substituted syrups for scored tablets based on WHO weight band dosing tables between May 2008 and December 2009 79% (186/236) questionnaires of children changing formulation were analysed 2.9 years (IQR 2.4,3.4)was median age of children at which formulation was changed 77% (144/186 ) of carers reported problems while using syrups such as volume, weight and transportation of bottles at the time of substitution * * *Parents/carers reported the children’s preferences Specific difficulties with scored tablets were expected by 53% (99/186) of carers but reported after 8 weeks by only 27% (50/186) (i.e. taste, swallowing and vomiting)

  3. COMPARISON OF SYRUPS AND TABLETS DISPENSED FOR 4 WEEKS IN 11.8KG AND 12 KG CHILDREN RESPECTIVELY CONCLUSIONS • Carers anticipated fewer difficulties using scored tablets than syrups, and experienced even fewer difficulties • After 8 weeks use most carers reported that children preferred scored tablets; none had switched back to syrups IMPLICATIONS • Scored tablets for young children cause few problems • Most children and almost all their carers prefer scored tablets We are eliciting long term information after 24 weeks on tablets and will also evaluate the affect of acceptability on adherence Syrups Tablets (scored)

  4. ACKNOWLEDGEMENTS • The children and their parents/carers • The ARROW clinical trial teams in Uganda and Zimbabwe • The MRC clinical trials unit • MRC UK, DFID and GSK

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