title: Children's medicines in Tanzania: a national survey of administration practices and preferences.
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.
  
  
  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.
authors.affiliation: Audrey and Theodor Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA. Lisa.V.Adams@Dartmouth.edu
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Adams
authors.forename: Sienna R
authors.initials: SR
authors.lastname: Craig
authors.forename: Elia John
authors.initials: EJ
authors.lastname: Mmbaga
authors.forename: Helga
authors.initials: H
authors.lastname: Naburi
authors.forename: Timothy
authors.initials: T
authors.lastname: Lahey
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Nutt
authors.forename: Rodrick
authors.initials: R
authors.lastname: Kisenge
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Noel
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Spielberg
mesh_terms: D002626:Chemistry, Pharmaceutical / Q000379:methods*; D002648:Child; D003430:Cross-Sectional Studies; D004522:Educational Status; D006801:Humans; D007407:Interviews as Topic; D010290:Parents; D010372:Pediatrics / Q000379:methods*; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D013636:Tanzania
chemical_list: D004364:Pharmaceutical Preparations