The prevalence of rheumatic heart disease in Ethiopia: a systematic review and meta-analysis

Berhanu, Hiwot; Mekonnen, Yimer; Workicho, Abdulhalik; Hassen, Kalkidan; Negeri, Zenebe; Sudhakar, Morankar; Mitiku, Shimelis; Mossie, Andualem

doi:10.1186/s40794-023-00192-y

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…The mean knowledge of warfarin therapy (59.35 ± 13.04%) obtained in the present study was comparable with the Hungarian study 59.39 (±17.62) 11 and a systematic review and meta-analysis report of 60.4% average level of knowledge on warfarin therapy 29 and slightly lower than that found by Hua et al 30 in China (62.3 ± 8.8%). However, the mean score in our study was much higher than that reported by Nader and co-workers, 31 with an overall mean score of 29.3%.…”

Section: Discussionsupporting

confidence: 86%

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Tadesse,

Yadeta,

Chelkeba

et al. 2024

Clin Appl Thromb Hemost

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Anticoagulation management using warfarin is challenging in clinical practice. This study aimed to evaluate the knowledge, adherence, and satisfaction with warfarin therapy and associated factors among outpatients at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. An interview-based cross-sectional study was conducted among 350 patients receiving warfarin therapy at cardiac and hematology clinics of TASH. Anticoagulation knowledge assessment (AKA) questionnaires assessed the patients’ warfarin knowledge. Adherence to warfarin was evaluated using the Morisky Green Levine Scale (MGLS), and patient satisfaction with warfarin therapy was assessed using the 17-item anticlot treatment scale (ACTS). Binary logistic regression was used to determine factors associated with the outcome variables, and p < .05 was used as the cut-off point to declare a significant association. The mean AKA score was 59.35 ± 13.04% (10.68 ± 2.34 correct answers), and 82 (23.4%) of participants achieved a passing score. Based on the MGLS, 192 (54.9%) study participants adhered well to warfarin. The mean level of satisfaction was 53.67 ± 8.56, with mean scores of 41.93 ± 7.80 and 11.74 ± 2.43 in the ACTS burden and benefit subscales, respectively. One hundred eighty-four (52.6%) patients were satisfied with warfarin therapy. The absence of hyperthyroidism was significantly associated with poor knowledge of warfarin therapy (adjusted odds ratio [AOR] = 4.28, 95% confidence interval [CI]: 1.01–18.22). Those living with family had a 56% lower chance of poor warfarin adherence (AOR: 0.44; 95% CI: 0.21–0.93) than those living alone. This study shows room for improvement in patient knowledge, adherence, and satisfaction with warfarin therapy.

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Section: Discussionsupporting

confidence: 86%

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Tadesse,

Yadeta,

Chelkeba

et al. 2024

Clin Appl Thromb Hemost

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“…11 Ethiopia, a nation heavily affected by RHD, experiences a significant burden from the disease. 12 Echocardiographic analysis across six major referral hospitals in Ethiopia has revealed that RHD constitutes as much as 40.5% of the reported cases. 13 Similarly, a study conducted at Dabat Health Centre in the Amhara region reported the highest prevalence of RHD-related mortality worldwide, with a rate of 125.3 per 1000 people.…”

Section: Introductionmentioning

confidence: 99%

Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center

Berhanu,

Mossie,

Morankar

et al. 2024

VHRM

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Background Despite the fact that patients with rheumatic heart disease (RHD) need early medical attention and follow-up, most patients in developing countries tend to present with debilitating complications. The objective of this study was to evaluate the echocardiographic features of adult individuals diagnosed with RHD and examine the associated complications among patients who started follow-up at Jimma Medical Center’s (JMC) cardiac follow-up clinic. Methods A prospective cross-sectional study was conducted at JMC between January 5 and April 15, 2023. Echocardiographic patterns were taken by senior cardiologists; socio-demographic variables, anthropometric measurements, and behavioral factors were collected through a structured questioner. Results The study recruited a total of 115 participants, of whom 86 (74.8%) were female and 29 (25.2%) were male. The mean age of the patients was 32.31 (SD± 12.16) years. The mitral valve was affected in 98.26% of cases, while the aortic and tricuspid valve abnormalities were diagnosed in 49.5% and 21.7%, respectively. The most frequent combinations of valve lesions were mitral regurgitation (MR) + mitral stenosis (MS) + aortic regurgitation (AR) (15.7%), followed by MR + AR + TR (8.7%). The occurrence of MR+MS+AR was higher in females (17.4%) compared to males (10.3%), whereas the occurrence of MS+MR was higher in males (24.1%) compared to females (20.9%). Females have a severely reduced ejection fraction compared to males (84.8% vs 15.2%, P = 0.044). Nearly two-thirds (63.5%) of individuals experienced RHD-related complications; the most commonly encountered complications were pulmonary hypertension (26.1%) and atrial fibrillation (19.1%). Conclusion RHD predominantly affects individuals in their active and productive years, particularly females. Most patients have multiple-valve lesions.

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Barriers and facilitators of benzathine penicillin G adherence among rheumatic heart disease patients: a mixed methods systematic review using the COM-B (capability, opportunity, and motivation for behavior) model

Areri,

Tadele,

Workneh

2024

Syst Rev

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Background Benzathine penicillin G (BPG) is a proven preventive agent for preventing the progression of rheumatic heart disease (RHD) and is recognized as a standard of care. However, ensuring adherence to BPG remains a global challenge. The objective of this review was to synthesize the available evidence on the barriers to and facilitators of BPG adherence among RHD patients. Methods This systematic review included both qualitative and quantitative studies on RHD patients published in the English language. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search strategy involved PubMed, Embase, CINAHL, Global Health, Scopus, and Web of Sciences databases to identify keywords and terms contained in the title and abstract and the index terms used to describe articles. The review included papers published from January 1, 2000, to March 30, 2024. Two independent reviewers screened, appraised, and extracted the data. The data analysis was carried out deductively to fit onto the components of the COM-B (Capability, Opportunity, Motivation-Behaviour) model. Results In this review, 1067 records were screened, and 22 studies with 7338 participants were included. Thirty-five barriers and twenty facilitators were identified and mapped onto COM-B components. Physical capability (e.g., felt healthy), psychological capability (e.g., lack of knowledge), reflective motivation (e.g., poor patient handling), automatic motivation (e.g., BPG injection pain), physical opportunity (e.g., BPG unavailability) and social opportunity (e.g., inadequate counseling) were identified as barriers. The most discussed barrier was automatic motivation, followed by psychological capability and physical opportunity. Conclusions Our review revealed variable levels of BPG adherence across studies and identified significant barriers and facilitators. Further research is recommended to identify contextual interventions to address barriers and capitalize on facilitators. Systematic review registration PROSPERO CRD42024535398.

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The prevalence of rheumatic heart disease in Ethiopia: a systematic review and meta-analysis

Cited by 3 publications

References 33 publications

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Echocardiographic Parameters and Complication Profiles Among Adult Patients with Rheumatic Heart Disease at Jimma Medical Center

Barriers and facilitators of benzathine penicillin G adherence among rheumatic heart disease patients: a mixed methods systematic review using the COM-B (capability, opportunity, and motivation for behavior) model

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