Rheumatic Heart Disease
Conditions
Brief summary
The primary objective of this study is to determine the impact of a pragmatic RHD primary prevention program in Uganda. The secondary Objective are as follow: 1. To improve guideline-based care for sore throat through frontline healthcare provider education on clinical decision rules and guideline-based primary prevention. 2. To increase health seeking behavior for sore throat thorough a multifaceted community awareness campaign.
Detailed description
Our intervention is designed as a service-oriented plan to be implemented through the primary healthcare structure and facilities of both the national health and private system. Additional support will come from the education system, with participation from schools, teachers, patients, patient families, and the public. Our intervention will focus on two of the more easily rectified impediments to primary prevention, namely (1) poor uptake of guideline-based treatments for Group A Streptococcal (GAS) pharyngitis and (2) low levels of public awareness of the importance of sore throat care and treatment.
Interventions
OTHERHealthcare provider education
Mix of training and educational activities within the district continuing medical education system targeting community health workers and frontline providers focused on the importance of sore throat and it's link to RHD, clinical guidelines to differentiate patients at high or low risk for GAS pharyngitis and guideline based care for treating GAS pharyngitis
OTHERCommunity Awareness campaign
A district wide public health campaign to increase community awareness of sore throat, including school based education, VHT community sensitization, education of parents and patients, radio messaging, posters, signs and billboards.
Sponsors
Uganda Heart Institute
Children's National Research Institute
Children's Hospital Medical Center, Cincinnati
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Pragmatic public health study to test an integrated strep education and treatment program to reduce echo-detected burden of RHD
Eligibility
Sex/Gender
ALL
Age
5 Years to 15 Years
Healthy volunteers
Yes
Inclusion criteria
• Has agreed to participate in the study via the study's informed consent/assent process.
Exclusion criteria
* Known history of ARF or RHD * Any known co-morbid conditions (HIV, renal deficiencies, severe malnutrition, * among others) that have resulted in prescription of regular antibiotic prophylaxis * Structural or functional cardiac defects, other than those consistent with RHD, that were known prior to or detected through echo screening (except patent foramen ovale, small atrial septal defect, small ventricular septal defect, small patent ductus arteriosus).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Determination of Echocardiography prevalence of RHD among children 5-15 years old | 2 year endpoint | Echocardiography screening of school age children in Uganda to determine prevalence of RHD prior to and 2 years post intervention |
Countries
Uganda
Outcome results
None listed