Acute rheumatic fever (ARF) is an autoimmune condition caused by untreated Group A Streptococcal (GAS) infection of the upper respiratory tract (and possibly skin). Multiple or severe attacks of ARF can cause cardiac damage known as rheumatic heart disease (RHD). The most effective recommended treatment of ARF requires monthly intramuscular injections of Benzathine Penicillin G (BPG) known as secondary prophylaxis. The goal of secondary prophylaxis is to prevent GAS infections that may lead to the recurrence of ARF. Rates of adherence to secondary prophylaxis schedules are usually low due to the frequency and duration of injection, pain and access to proper and timely healthcare services. A less painful and longer acting BPG formulation would ideally help prevent ARF recurrence and improve compliance rates to this schedule. The purpose of this work is to explore the BPG reformulation preferences of children and teens currently receiving monthly BPG intramuscular injections, in addition to their families and healthcare providers. A software application has been developed that will explore the experiences of the groups who will then choose their ideal BPG formulation from a range of plausible formulations and associated dosing regimens. The software application has been optimized for use to ensure age and cultural appropriateness and also efficient data collection. Pretesting of the software has been undertaken which has received positive responses with the piloting stage initiated. This is the first time a software application has been successfully developed to collect qualitative and quantitative data on individual preferences for BPG formulations and dosing regimens.
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