Reluctance/refusal by children.
SAID
Refusal to take the combined drugs was reported by some children across all age groups but was most pronounced among 10 to 14-year-old children. It was difficult to find these children at home at the time of the drug administration, and some deliberately left home on drug administration days and did not return home until late in the night. The trial staff felt this behavior was probably because this was the first time that the adolescents were included in the SMC campaigns. This notion was corroborated by a group of adolescents who were interviewed to understand why they refused to take the medications. Some admitted that that they were ashamed of being asked to urinate or pass stool in a sample collecting bottle, especially by a trial staff member of the opposite sex. Others attributed their reluctance to the mockery they suffered from their friends who said they were treated as younger children whose stool and urine were collected after receiving snacks.We encountered a lot of difficulty, especially when we went to a house and we can’t find the child concerned, in which case we have to leave and come back because we don’t leave the medicines with the mothers, because it is not sure that they will administer the drugs to the children, which is why sometimes we stay in the field until 11 The conversations below between the interviewer and a parent also underscored the gender sensitivity displayed by the adolescent participants:I remember that, because I had a child, a boy who refused to allow these people to take his stool.How old was the child? He is 13 years old today, I believe.Why do you think he refused? The first day they came to my house to take his stools, at the time I had gone to the farm. But when I arrived, his mother told me that. I asked him why he refused, and he told me that it was a woman who had wanted to take his stool. So I asked the staff to come back because they were still here in the village and I personally took the stool and I gave it to a gentleman.So, if I understand correctly, it’s the fact that it’s a woman that the boy refused?” For the boys it must be men and for the women too because they are ashamed to see a woman take their stool like that, it bothers them. Refusal of the medications was also predicated on the size and taste of some of the drugs. The trial staff and healthcare providers submitted that albendazole had a pleasant taste, which made it more acceptable to the children while amodiaquine and praziquantel are bitter and consequently, many children were reluctant to take them, and some rejected them totally.The first day that we started giving the drugs to the children, we had problems with them, because the drugs are bitter. Some take it straight, but for others you have to pound the medicine to give it to them. The drug like praziquantel is a bit big. Now I don’t know what to do, but I think we will have to try to see another alternative, it can be the same tablet, but it will have to be reduced in size. And also, if it’s possible to do it with a little sugar, so swallowing it will be much easier. 