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Penicillin Levels for Rheumatic Heart Disease Study - WA Urban Cohort

Investigators: Amy Baker, Dianne Sika-Paotonu, Jonathan Carapetis, Julie Marsh, Katherine Gray, Nelly Newall, Robert Hand

External investigators: Laurens Manning (University of Western Australia), Sam Salman (University of Western Australia), James Ramsay (Department of Health WA), Julie Vine (Department of Health WA), Julie Hart (Department of Health WA), John Joseph (Department of Health WA)

Secondary prophylaxis administration is one of the greatest global challenges in RHD control. Few control programs consistently deliver more than 80% of scheduled BPG injections. Many barriers to adherence are functions of the formulation of BPG: frequent administration (every 28 days) & painful intramuscular injection. These limitations have prompted calls for improved BPG formulations. 

This is a 6 month cohort study involving participants at Princess Margaret Hospital prescribed BPG for secondary prophylaxis of RHD. Dry blood spot (DBS) samples & throat swabs will be collected from each child. DBS samples will be used to measure plasma penicillin levels & group A streptococcal (GAS) antibody titres immediately prior to BPG administration & at pre-specified time points within each BPG cycle. Throat swabs will be cultured to determine the presence of GAS infection.