Unknown

Dataset Information

0

Rheumatic Heart Disease Treatment Cascade in Uganda.


ABSTRACT: BACKGROUND:Rheumatic heart disease (RHD) is a leading cause of premature death and disability in low-income countries; however, few receive optimal benzathine penicillin G (BPG) therapy to prevent disease progression. We aimed to comprehensively describe the treatment cascade for RHD in Uganda to identify appropriate targets for intervention. METHODS AND RESULTS:Using data from the Uganda RHD Registry (n=1504), we identified the proportion of patients in the following care categories: (1) diagnosed and alive as of June 1, 2016; (2) retained in care; (3) appropriately prescribed BPG; and (4) optimally adherent to BPG (>80% of prescribed doses). We used logistic regression to investigate factors associated with retention and optimal adherence. Overall, median (interquartile range) age was 23 (15-38) years, 69% were women, and 82% had clinical RHD. Median follow-up time was 2.4 (0.9-4.0) years. Retention in care was the most significant barrier to achieving optimal BPG adherence with only 56.9% (95% confidence interval, 54.1%-59.7%) of living subjects having attended clinic in the prior 56 weeks. Among those retained in care, however, we observed high rates of BPG prescription (91.6%; 95% confidence interval, 89.1%-93.5%) and optimal adherence (91.4%; 95% confidence interval, 88.7-93.5). Younger age, latent disease status, and access to care at a regional center were the strongest independent predictors of retention and optimal adherence. CONCLUSIONS:Our study suggests that improving retention in care-possibly by decentralizing RHD services-would have the greatest impact on uptake of antibiotic prophylaxis among patients with RHD in Uganda.

SUBMITTER: Longenecker CT 

PROVIDER: S-EPMC5728153 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

altmetric image

Publications


<h4>Background</h4>Rheumatic heart disease (RHD) is a leading cause of premature death and disability in low-income countries; however, few receive optimal benzathine penicillin G (BPG) therapy to prevent disease progression. We aimed to comprehensively describe the treatment cascade for RHD in Uganda to identify appropriate targets for intervention.<h4>Methods and results</h4>Using data from the Uganda RHD Registry (n=1504), we identified the proportion of patients in the following care categor  ...[more]

Similar Datasets

| S-EPMC8363312 | biostudies-literature
| S-EPMC8782090 | biostudies-literature
| S-EPMC4712089 | biostudies-literature
2022-07-29 | GSE209591 | GEO
| S-EPMC9951636 | biostudies-literature
| S-EPMC7428530 | biostudies-literature
| S-EPMC7799147 | biostudies-literature
2016-07-06 | E-GEOD-84003 | biostudies-arrayexpress
| S-EPMC9303429 | biostudies-literature
| S-EPMC8878614 | biostudies-literature