The Benzathine Penicillin G (Bpg) Reformulation Preferences Study - Samoa

Abstract 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). In Australia, New Zealand (NZ) and the Pacific Region, the disease burden of ARF and RHD amongst Indigenous and Pacific communities is one of the highest in the world, usually affecting children and young adults. The most effective recommended management for ARF requires monthly intramuscular injections of 1.2 million units of Benzathine Penicillin G (BPG) known as secondary prophylaxis (SP) for 10 years or more. The goal of SP is to prevent GAS infections that may lead to the recurrence of ARF. Even with these monthly BPG injections, adherence to SP schedules are usually low due to the frequency and duration of injection, pain and access to proper and timely healthcare. A less painful and longer acting BPG formulation would ideally help prevent recurrence of ARF and improve compliance rates to this schedule with improved understanding of barriers and novel approaches to BPG delivery urgently needed. To better understand the BPG reformulation preferences of children/teens currently receiving monthly BPG intramuscular injections, and that of their families and healthcare providers who administer BPG, three software applications will be developed from pre-existing applications that have been optimized for use in target populations in New Zealand. This will be the first time software applications have been used to collect qualitative and quantitative data on individual preferences for BPG formulations and dosing regimens in Samoa.