Abstract:
Background: Rheumatic heart disease continues to create havoc in the developing countries even
decades after its discovery. It is entirely preventable through primordial, primary, and secondary
level intervention. Secondary prevention is a reasonable treatment option in patients in Ethiopia, but
good adherence to the treatment is essential to achieve the desired objective. Information regarding
prevalence of good adherence and factors associated with poor adherence is limited in Ethiopia.
Objective: The aim of this study was to assess the prevalence of good adherence with secondary
prophylaxis for rheumatic heart disease and identify factors associated with poor adherence among
patients on treatment at hospitals in Jimma zone.
Methods: A hospital based cross sectional study was conducted from August –November, 2019 on
selected rheumatic heart disease patients on follow-up at Jimma Medical Center, Shenen Gibe
Hospital, Agaro Hospital and Seka Chekorsa Hospital. Data was collected by face-to-face interview
and record review using semi-structured questionnaire and checklist respectively. Adherence of the
last consecutive 12 months before the interview was assessed as outcome. The collected data was
entered into EpiData, and cleaned and analyzed using SPSS 23.
Result: Results: A total of 253 patients with rheumatic heart disease taking Benzathine Penicillin
were included in the analysis. One hundred seventy-eight (70.4%) of them were females. One
hundred nine (43.1%) of them were in the age group of above 24 years. Our study showed that
36.8%of patients from the four hospitals in Jimma Zone receiving antibiotic prophylaxis for
rheumatic heart disease had a rate of adherence <80% and were therefore at high risk of recurrence
of acute rheumatic fever. The main reasons to miss their prophylaxis among Rheumatic heart disease
patients were long distance from the treatment setting (56.9%) followed by lack of money (38%).
Conclusion and recommendation: Multivariable analysis showed that lower education of the
patients, living in rural areas, and low knowledge about the disease were independently associated
with poor adherence to medication. Further research and solutions directly targeting these barriers
can improve patient adherence and decrease their overall risk of rheumatic heart disease
