ArticleGlobal health research and policy2021
Health system and patient-level factors serving as facilitators and barriers to rheumatic heart disease care in Sudan.
Article in Global health research and policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Patient reported barriers and facilitators of chronic kidney disease care in Sub-Saharan Africa: a mixed methods systematic review using the COM-B model.BMC nephrology · 2025Pooled it
- Barriers and facilitators of benzathine penicillin G adherence among rheumatic heart disease patients: a mixed methods systematic review using the COM-B (capability, opportunity, and motivation for behavior) model.Systematic reviews · 2024Pooled it
- Article
- Community-informed trial design and implementation to optimize recruitment and retention in low-income settings: lessons from rheumatic heart disease trials in Uganda.Frontiers in cardiovascular medicine · 2026Article
- Characteristics and Problems of Rheumatic Heart Disease in Indonesia: The Ina-RHD Multicenter Study.JACC. Asia · 2025Article
- Healthcare accessibility, utilization, and quality of life among internally displaced people during the Sudan war: a cross-sectional study.Conflict and health · 2025Article
- Breaking ground: insights from a WHO-approved surgical mission amid Sudan's healthcare collapse.Frontiers in public health · 2025Article
- Acceptability and Implementation Challenges of Benzathine Penicillin G Secondary Prophylaxis for Rheumatic Heart Disease in Ethiopia: A Qualitative Study.Global heart · 2025Article
- Article
- Health-related quality of life and healthcare consultations among adult patients before and after diagnosis with rheumatic heart disease in Namibia.BMC cardiovascular disorders · 2023Article
- A Qualitative Study of Patients' Experiences, Enablers and Barriers of Rheumatic Heart Disease Care in Uganda.Global heart · 2023Article
- Rheumatic heart disease prevalence in Namibia: a retrospective review of surveillance registers.BMC cardiovascular disorders · 2022Article
- Offering health despite all risks.Sudanese journal of paediatrics · 2022Article
- Moving forwards amidst the griefs.Sudanese journal of paediatrics · 2022Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRheumatic heart disease (RHD) remains a leading cause of morbidity and mortality in Sub-Saharan Africa despite widely available preventive therapies such as prophylactic benzathine penicillin G (BPG). In this study, we sought to characterize facilitators and barriers to optimal RHD treatment with BPG in Sudan.
methodsWe conducted a mixed-methods study, collecting survey data from 397 patients who were enrolled in a national RHD registry between July and November 2017. The cross-sectional surveys included information on demographics, healthcare access, and patient perspectives on treatment barriers and facilitators. Factors associated with increased likelihood of RHD treatment adherence to prophylactic BPG were assessed by using adjusted logistic regression. These data were enhanced by focus group discussions with 20 participants, to further explore health system factors impacting RHD care.
resultsOur quantitative analysis revealed that only 32% of the study cohort reported optimal prophylaxis adherence. Younger age, reduced primary RHD healthcare facility wait time, perception of adequate health facility staffing, increased treatment costs, and high patient knowledge about RHD were significantly associated with increased odds of treatment adherence. Qualitative data revealed significant barriers to RHD treatment arising from health services factors at the health system level, including lack of access due to inadequate healthcare staffing, lack of faith in local healthcare systems, poor ancillary services, and patient lack of understanding of disease. Facilitators of RHD treatment included strong interpersonal support.
conclusionsMultiple patient and system-level barriers to RHD prophylaxis adherence were identified in Khartoum, Sudan. These included patient self-efficacy and participant perception of healthcare facility quality. Strengthening local health system infrastructure, while enhancing RHD patient education, may help to improve treatment adherence in this vulnerable population.
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