Adherence for benzanthine penicillin as secondary prophylaxis and factors associated with it among children with rheumatic heart disease attending the cardiac clinic of Jimma University Specialized Hospital from 2011-2015 GC

Abstract

Background: Secondary prophylaxis is directed at preventing acute GAS pharyngitis in patients at substantial risk of recurrent acute rheumatic fever. Intramuscular benzanthine penicillin is the most effective method for secondary prophylaxis against acute rheumatic fever whose efficacy largely depends on adherence to treatment. The level of adherence required to prevent further episodes of ARF is not known, but the objective is to reach 100% of the annual expected BPG injections, with a recommended benchmark of 80%. Objective: The objective of this study was to assess adherence for benzanthine penicillin as secondary prophylaxis and factors associated with it among children with rheumatic heart disease attending the cardiac clinic of JUSH, Jimma, Ethiopia from 2011-2015 GC. Methods: A longitudinal cohort study, with study population of children with documented rheumatic heart disease or acute rheumatic fever who were on monthly benzanthine G penicillin prophylaxes was done by analyzing a secondary data which was collected by the Rheumatic Heart Disease Registry (REMEDY) group over 2 years. Data was analyzed using SPSS version 21, and appropriate description for the study variables is depicted by cross-tabulation, graphs and association of variables were done using chi-square, linear logistic regression accordingly with p-value <0.05 used as significant for associated variables. Results: This study showed that at both 1st & 2nd year of study majority of the children were adherent to BGP prophylaxis with rates of 91% & 86% respectively. There were 12 (3/1st year, 9/2nd year) children who received no injection at all. Use of other cardiac supportive drugs was a protective factor against poor adherence (OR, 0.14; 95% CI, 0.03-0.85), while disease severity & type of valves involved weren’t predictors for adherence to BGP. Conclusion: Although the adherence level of this study was good, further improvement of patients and caregivers understanding of the disease & the benefits of BGP adherence should be sought.