Rheumatic Fever and Rheumatic Heart Disease in Barbados: Detection and Prophylaxis

Hassell, Trevor; Renwick, Sonia; Stuart, K. L.

doi:10.1136/bmj.3.5823.387

Cited by 12 publications

(5 citation statements)

References 4 publications

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“…16 An uncontrolled evaluation of a secondary prophylaxis program in Barbados demonstrated that supporting ARF/RHD patients to self-manage through the use of patient-carried cards to record injection dates may be effective. 46,47 This program was associated with the administration of 97% of possible doses of therapy by patients. However, the specific impact of the patient cards could not be separated from other confounding factors, including the fact that their introduction coincided with the establishment of an ARF/RHD clinic at the local hospital.…”

Section: Clinical Practicementioning

confidence: 99%

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Rémond

Coyle

Mills

et al. 2016

Cardiology in Review

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Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are autoimmune conditions resulting from infection with group A streptococcus. Current management of these conditions includes secondary antibiotic prevention. This comprises regular 3 to 4 weekly long-acting intramuscular benzathine penicillin injections. Secondary antibiotic prevention aims to protect individuals against reinfection with group A streptococcus, thereby preventing recurrent ARF and the risk of further damage to the heart valves. However, utilization of benzathine penicillin can be poor leaving patients at risk of avoidable and progressive heart damage. This review utilizes the Chronic Care Model as a framework to discuss initiatives to enhance the delivery of secondary antibiotic prophylaxis for ARF and RHD. Results from the search strategy utilized revealed that there is limited pertinent published evidence. The evidence that is available suggests that register/recall systems, dedicated health teams for delivery of secondary antibiotic prophylaxis, education about ARF and RHD, linkages with the community (particularly between health services and schools), and strong staff-patient relationships may be important. However, it is difficult to generalize findings from individual studies to other settings and high quality studies are lacking. Although secondary antibiotic prophylaxis is an effective treatment for those with ARF or RHD, the difficulties in implementing effective programs that reduce the burden of ARF and RHD demonstrates the importance of ongoing work in developing and evaluating research translation initiatives.

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Section: Clinical Practicementioning

confidence: 99%

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Rémond

Coyle

Mills

et al. 2016

Cardiology in Review

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“…(1) Barbados,104 (2) Cook Islands,21 (3) El Salvador,202 (4) Fiji,112 (5) French Polynesia,112 (6) Jamaica,202 (7) Puerto Rico,103 (8) Samoa,112 (9) Tonga,112,136 (10) Minnesota 86…”

Section: Figurementioning

confidence: 99%

“… Map showing reported worldwide incidence of ARF from 1970 through 1990. 86 , 97 , 104 – 156 (1) Barbados, 104 , 105 (2) Fiji, 112 (3) French Antilles, 113 (4) French Polynesia, 112 (5) Federated States of Micronesia, 114 (6) Israel, 120 (7) Kuwait, 123 – 125 (8) New Caledonia, 112 (9) Northern Mariana Islands, 133 (10) Samoa, 112 (11) Tonga, 112 , 136 (12) Trinidad, 137 (13) Alabama, 140 (14) Arizona, 97 (15) California, 141 , 142 (16) Florida, 143 (17) Hawaii, 144 – 146 (18) Minnesota, 86 (19) Mississippi, 147 (20) Navajo Reservation, 148 (21) Ohio, 149 , 150 (22) Rhode Island, 151 (23) Tennessee, 152 (24)Utah, 93 (25) Virginia, 153 (26) West Virginia, 154 , 155 (27) Wyoming. 97 …”

Section: Figurementioning

confidence: 99%

“… Map showing reported worldwide prevalence of RHD from 1970 through 1990. 14 , 21 , 86 , 90 , 99 , 102 – 104 , 111 , 112 , 118 , 128 , 132 , 136 , 201 – 216 (1) Barbados, 104 (2) Cook Islands, 21 (3) El Salvador, 202 (4) Fiji, 112 (5) French Polynesia, 112 (6) Jamaica, 202 (7) Puerto Rico, 103 (8) Samoa, 112 (9) Tonga, 112 , 136 (10) Minnesota. 86 …”

Section: Figurementioning

confidence: 99%

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The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease

Seckeler¹,

Hoke²

2011

CLEP

387

287

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“…9 The difficulties that patients might face in reaching the clinic on regular basis, the painful nature of these injections, and a lack of awareness and understanding may form a combination of barriers that collectively lead to these low adherence rates. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

An evaluation of secondary prophylaxis for rheumatic heart disease in rural Egypt

Balbaa

ElGuindy

Pericak

et al. 2015

Global Cardiology Science and Practice

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Background: Although essentially disappeared from the industrialized world, rheumatic heart disease (RHD) is still prevalent in developing countries, with 300,000 new cases identified each year. In Aswan, Egypt, RHD affects about 2.3% of children with over 90% of the cases being subclinical. Secondary prophylaxis has proved to be an effective method of preventing the progression of RHD. However, its efficacy is limited by low patient adherence. A systematic, generalizable tool is necessary to outline, and ultimately address these barriers. Methods: A 43-item semi-structured questionnaire was developed based on the three domains outlined by Fishbein (capability, intention, and health care barriers). A preliminary evaluation of the barriers to RHD prophylaxis use in Aswan, Egypt was carried out as a pilot study using this tool. Participants were local school children diagnosed with RHD or flagged as high-risk (as per a set of echocardiographic criteria developed by the Aswan Heart Centre) through a previous screening program of randomly selected 3,062 school children in Aswan. Results: 29 patients were interviewed (65.5% adherent to RHD prophylaxis). Compared to non-adherent patients, adherent patients had better understanding of the disease (68.4% versus 20% in the non-adherent group, p = 0.021), and were more aware of the consequences of missing prophylaxis doses (79% versus 40% of non-adherent patients, p = 0.005). Furthermore, 90% of non-adherent patients consciously choose to miss injection appointments (as compared to 31.6% of adherent patients, p = 0.005). Clinic wait time was the most frequently reported deterrent for both groups. Conclusion: A standardized tool that systematically outlines barriers to prophylaxis is a necessary first step to improving adherence to penicillin. Although individually developed tools exist for specific populations, a generalizable tool that takes into account the demographic and cultural differences in the populations of interest will allow for more reliable data collection methodology. Application of this tool will be used to further explore barriers to prophylaxis adherence and inform the basis for the design of future KT interventions.

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Rheumatic Fever and Rheumatic Heart Disease in Barbados: Detection and Prophylaxis

Cited by 12 publications

References 4 publications

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

Approaches to Improving Adherence to Secondary Prophylaxis for Rheumatic Fever and Rheumatic Heart Disease

The worldwide epidemiology of acute rheumatic fever and rheumatic heart disease

An evaluation of secondary prophylaxis for rheumatic heart disease in rural Egypt

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