Utilization and Barriers to Secondary prophylaxis for Rheumatic Heart disease at Tikur Anbessa Specialized Hospital adults outpatient clinic, Addis Ababa, Ethiopia.

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Addis Abeba University


Background: Rheumatic heart disease (RHD) is one of the major causes of cardiovascular disease in developing countries, affecting most of the young population. Secondary prophylaxis in the form of benzathine penicillin is effective for preventing recurrent acute rheumatic fever (ARF) and the progression of RHD. However, the low adherence rate reduced the effectiveness. Therefore, a systematic generalizable tool is necessary to tackle the barriers. Objective: The purpose of the study was to assess adherence and barriers to use secondary prophylaxis for RHD, at Tikur Anbessa specialized hospital (TASH). Methods: Cross-sectional study was conducted from June 5, 2020, to September 4, 2020, at Tikur Anbessa Specialized Hospital, Ethiopia. A structured questioner was used for the data collection on awareness, adherence, and barriers for benzathine penicillin prophylaxis in adults with RHD. Data were analyzed using SPSS version 26. Results: A total of 385 patients participated in this study, 305(79.6%) patients were aware, sore throat associated with heart disease, and about 288 (75.6%) patients; know that benzathine penicillin prevents tonsillitis. The adherence rate was 77.9% for benzathine penicillin prophylaxis (BPG) while the left 85 patients (22.1%) were non-adhered to the prophylaxis. The main barriers for none adherence in this study were the nonavailability of medication, forgetting, and health professionals refuse to inject benzathine penicillin. Increased age was found to have a significant association with adherence to BPG. For each one-year increase in the age of patients with RHD, the percent odds of adherence decreases by 3% (P value 0.006) Conclusion: Adherence level was low, which is below WHO recommendation. This study insight important major barriers that affect secondary prophylaxis for RHD that can be used to develop an intervention to improve adherence.



Rheumatic heart disease, adherence, barriers, secondary prophylaxis, Tikur Anbessa specialized Hospital