Rheumatic Heart Disease Control Programs, Registers, and Access to Care

Wyber, Rosemary; Kado, Joseph

doi:10.1016/b978-0-323-63982-8.00012-x

Cited by 2 publications

(2 citation statements)

References 91 publications

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“…A well-designed, evidence-based national prevention and treatment strategy is an essential tool to improve care and outcomes. Experience from other countries suggests that an evidence-based national strategy and register-based RHD control programs can improve access for patients with RHD [ 19 – 21 ]. The objectives of this study were to evaluate the level of adherence to RHD prophylaxis and to identify risk factors for poor adherence in Ethiopian children as a first step towards informing effective national prevention, control, and treatment strategies.…”

Section: Introductionmentioning

confidence: 99%

Secondary prevention of rheumatic heart disease in Ethiopia: a multicenter study

Belay

Dessie

Ahmed

et al. 2022

BMC Cardiovasc Disord

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Background Ethiopia has a high acute rheumatic fever (ARF) and rheumatic heart disease (RHD) prevalence, and to our knowledge, there are no data on the status of secondary prevention in children with RHD. This study describes the status of secondary RHD prevention. Methods A multicenter, prospective study was performed on children aged 5–17 years with RHD in Ethiopia. Good adherence was defined as at least 80% completion of benzathine penicillin (BPG) or oral Amoxicillin within the previous year. The primary outcome measure was adherence to prophylaxis, expressed as a proportion. Socio-demographics, severity of RHD, and ARF recurrence were evaluated. Results A total of 337 children with a mean age of 12.9 ± 2.6 years were included. The majority (73%) had severe aortic/mitral disease. Participants were on BPG (80%) or Amoxicillin (20%) prophylaxis. Female sex (P = 0.04) use of BPG (0.03) and shorter mean duration of prophylaxis in months (48.5 ± 31.5 vs. 60.7 ± 33, respectively, P < 0.008) predicted good adherence. Running out of medications (35%), interrupted follow-up (27%), and the COVID-19 pandemic (26%) were the most common reasons for missing prophylaxis. Recurrence of ARF was higher in participants on Amoxicillin compared with BPG (40% vs. 16%, P < 0.001) and in those with poor adherence compared with good adherence (36.8% vs. 17.9%, respectively, P = 0.005). Type and duration of prophylaxis (OR 0.5, CI = 0.24, 0.9, P = 0.02; OR = 1.1, CI = 1.1, 1.2, P = 0.04, respectively), and sex (OR = 1.9, CI = 1.1, 3.4, P = 0.03) were independent predictors of poor adherence. Conclusion Poor adherence is prevalent in Ethiopian children living with RHD. Amoxicillin is a suboptimal option for prophylaxis as its use is associated with lower adherence and a higher rate of ARF recurrence.

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Section: Introductionmentioning

confidence: 99%

Secondary prevention of rheumatic heart disease in Ethiopia: a multicenter study

Belay

Dessie

Ahmed

et al. 2022

BMC Cardiovasc Disord

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“…Previous studies have demonstrated a decrease in the rates of ARF recurrences by 87% to 96% [ 9 ] and reductions in complications associated with RHD with the regular administration of BPG [ 1 , 10 ]. The World Health Organization (WHO) recommends that countries faced with high ARF/RHD rates have “adequate monitoring and surveillance, as an integrated component of national health systems responses” [ 2 , 11 ]; for an overview of the evolution of ARF/RHD registers globally, see [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Case Ascertainment on Australian Registers for Acute Rheumatic Fever and Rheumatic Heart Disease

Agenson

Katzenellenbogen

Seth

et al. 2020

IJERPH

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In Australia, disease registers for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were previously established to facilitate disease surveillance and control, yet little is known about the extent of case-ascertainment. We compared ARF/RHD case ascertainment based on Australian ARF/RHD register records with administrative hospital data from the Northern Territory (NT), South Australia (SA), Queensland (QLD) and Western Australia (WA) for cases 3–59 years of age. Agreement across data sources was compared for persons with an ARF episode or first-ever RHD diagnosis. ARF/RHD registers from the different jurisdictions were missing 26% of Indigenous hospitalised ARF/RHD cases overall (ranging 17–40% by jurisdiction) and 10% of non-Indigenous hospitalised ARF/RHD cases (3–28%). The proportion of hospitalised RHD cases (36%) was half the proportion of hospitalised ARF cases (70%) notified to the ARF/RHD registers. The registers were found to capture few RHD cases in metropolitan areas (SA Metro: 13%, QLD Metro: 35%, WA Metro: 14%). Indigenous status, older age, comorbidities, drug/alcohol abuse and disease severity were predictors of cases appearing in the hospital data only (p < 0.05); sex was not a determinant. This analysis confirms that there are biases associated with the epidemiological analysis of single sources of case ascertainment for ARF/RHD using Australian data.

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Rheumatic Heart Disease Control Programs, Registers, and Access to Care

Cited by 2 publications

References 91 publications

Secondary prevention of rheumatic heart disease in Ethiopia: a multicenter study

Secondary prevention of rheumatic heart disease in Ethiopia: a multicenter study

Case Ascertainment on Australian Registers for Acute Rheumatic Fever and Rheumatic Heart Disease

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