Jawaid Akbar Sial, Muhammad Tariq Farman, Mahesh Kumar Batra, Musa Karim.
Adherence to secondary prophylaxis of rheumatic fever in patients with rheumatic heart disease in rural areas.
Pak Heart J Jan ;51(3):243-7.

Objective: To determine adherence to secondary prophylaxis of rheumatic fever in patients with rheumatic heart disease presenting to cardiology department. Methodology: This cross-sectional study was conducted at Cardiology department of Chandka Medical College Larkana from 15th January to 14th April 2015. Patients with documented history of rheumatic heart disease (RHD) of 1 year presenting either to emergency or outpatient department were included.Frequency of intramuscular benzathine penicillin injection during last one year was recorded. Patients with frequency of at least 12 injections, i.e. 80% of the expected injections, per year were classified as adherent. Collected data was entered and analyzed using SPSS version 21. P < 0.05 was taken as criteria for statistical significance. Results: Total 102 patients were included in study out of which 70 (68.8%) were females. 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 valve involvement along with mitral valve. LV dysfunction was not present in majority the patients 73 (71.6%). Total of 75 (73.5%) patients were adherent to the secondary prophylaxis. Significantly lesser adherence was observed among the patients presenting to emergency department [19 (59.4%) vs. 56 (80.0%)] p=0.028. Adherence was found to be strongly associated with valvular lesion.(p=0.009). Conclusion: Secondary prophylaxis for rheumatic fever was being utilized by three quarter of patients and it was correlated with age and type of valvular lesions.

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