ADHERENCE TO SECONDARY PROPHYLAXIS OF RHEUMATIC FEVER IN PATIENTS WITH RHEUMATIC HEART DISEASE IN RURAL AREAS

Abstract

Objective: To determine adherence to secondary prophylaxis of rheumatic feverin patients with rheumatic heart disease presenting to cardiology department. Methodology: This cross-sectional study was conducted at Cardiologydepartment of Chandka Medical College Larkana from 15th January to 14th April2015. Patients with documented history of rheumatic heart disease (RHD) of 1year presenting either to emergency or outpatient department were included.Frequency of intramuscular benzathine penicillin injection during last one yearwas recorded. Patients with frequency of at least 12 injections, i.e. 80% of theexpected injections, per year were classified as adherent. Collected data wasentered and analyzed using SPSS version 21. P Ü 0.05 was taken as criteria forstatistical significance. Results: Total 102 patients were included in study out of which 70 (68.8%) werefemales. Age of the patients range from 11 years to 70 years with mean of 34.09±16.22 years. About 70 (68.8%) patients presented to out patients department.All patients had mitral valve involvement and 12 (11.8%) patients had aortic valveinvolvement along with mitral valve. LV dysfunction was not present in majoritythe patients 73 (71.6%). Total of 75 (73.5%) patients were adherent to thesecondary prophylaxis. Significantly lesser adherence was observed among thepatients presenting to emergency department [19 (59.4%) vs. 56 (80.0%)]p=0.028. Adherence was found to be strongly associated with valvularlesion.(p=0.009). Conclusion: Secondary prophylaxis for rheumatic fever was being utilized bythree quarter of patients and it was correlated with age and type of valvularlesions. Key Words: Rheumatic Fever, Rheumatic Heart Disease, Adherence, SecondaryProphylaxis, Penicillin