[e-drug] Information wanted on ARV Dispensing Guidelines For Children (4)

["Ruth Hope" <ruth.hope@verizon.net>]

E-DRUG: Information wanted on ARV Dispensing Guidelines For Children (4)
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Colleagues on this listserv have referred Salisu to good sources of
information on ART for treating paediatric AIDS.  However, none of the
referred resources address the actual dispensing of ARVs for paediatric use.

Issues include:
* how many weeks medication to dispense -- is this different for
recommendations for adults
* what guidance and how to give the guidance on storage of ARVs -- 
especially syrups
* how to check for compliance with treatment previously dispensed
* what to do if there are no paediatric formulations
* my personal recommendation is that tablets that require halving should be
halved in the pharmacy and not by the guardian in the home
* how to teach guardians to give drugs to children -- time of
day/dosage/with food/without food.
   ** this is particularly difficult with non-literate guardians
   ** where guardians do not have a watch
   ** where guardians have reduced visibility (many grandparents in Africa have cataracts and cannot see graduations on a syringe for measuring syrups)
* how to store paediatric formulations, particularly syrups, in the pharmacy

I do not know of any written guidance on this subject.  However,the Mildmay
Centre in Kampala, Uganda < http://www.mildmay.org.uk/UgandaCentre.html >
has guidelines for their own staff on all aspects of care and treatment of
children.  I recommend that Salisu contacts them.  This might encourage the
Mildmay to publish guidelines from their experience in Uganda, if they have
not yet done so!

The only details I can find on the Mildmay International website is actually
in London:
  Mildmay can work with you to develop services
  Contact Graham Blois, director of international development, to discuss
your needs
  tel + 44 1702 394450
  fax + 44 1702 394454
  post:
  Mildmay International
  1 Nelson Mews,
  Southend-on-Sea,
  Essex SS1 1AL,
  United Kingdom
  e-mail graham.blois@mildmay.org

Yours,  Ruth Hope
ruth.hope@verizon.net