Imperial College London
Alternate

Professor SirMagdiYacoub

Faculty of Medicine, National Heart & Lung Institute

Emeritus Professor
 
 
 
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Contact

 

+44 (0)1895 828 893m.yacoub

 
 
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Location

 

Heart Science Centre, HarefieldHarefield HospitalHarefield Hospital

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Summary

 

Publications

Citation

BibTex format

@article{Balbaa:2015:10.5339/gcsp.2015.40,
author = {Balbaa, A and ElGuindy, A and Pericak, D and Yacoub, MH and Schwalm, JD},
doi = {10.5339/gcsp.2015.40},
journal = {Global Cardiology Science and Practice},
pages = {40--40},
title = {An evaluation of secondary prophylaxis for rheumatic heart disease in rural Egypt.},
url = {http://dx.doi.org/10.5339/gcsp.2015.40},
volume = {2015},
year = {2015}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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
AU  - Balbaa,A
AU  - ElGuindy,A
AU  - Pericak,D
AU  - Yacoub,MH
AU  - Schwalm,JD
DO  - 10.5339/gcsp.2015.40
EP  - 40
PY  - 2015///
SN  - 2305-7823
SP  - 40
TI  - An evaluation of secondary prophylaxis for rheumatic heart disease in rural Egypt.
T2  - Global Cardiology Science and Practice
UR  - http://dx.doi.org/10.5339/gcsp.2015.40
UR  - http://www.ncbi.nlm.nih.gov/pubmed/26779516
UR  - http://hdl.handle.net/10044/1/29560
VL  - 2015
ER  -
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