Evidence map›Paper›PMID 35109807›Full record

ArticleBMC cardiovascular disorders2022

Secondary prevention of rheumatic heart disease in Ethiopia: a multicenter study.

Wubishet Belay, Azene Dessie, Hayat Ahmed, Etsegenet Gedlu, Abinet Mariyo, Abdulkadir Shehibo, Zemene Tigabu, Muktar H Aliyu, Jonathan Soslow

Open access · goldAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 2 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Wubishet BelayMonroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way 5th Floor, Nashville, TN, 37232, USA. Wubishet.belay@vumc.org.
Azene DessieCardiac Center Ethiopia, Addis Ababa, Ethiopia.
Hayat AhmedBlack Lion Specialized Referral Hospital, Addis Ababa University College of Medicine and Health Sciences, Addis Ababa, Ethiopia.
Etsegenet GedluBlack Lion Specialized Referral Hospital, Addis Ababa University College of Medicine and Health Sciences, Addis Ababa, Ethiopia.
Abinet MariyoCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Abdulkadir ShehiboCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Zemene TigabuCollege of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Muktar H AliyuVanderbilt Institute for Global Health (VIGH), Nashville, TN, USA.
Jonathan SoslowMonroe Carell Jr. Children's Hospital at Vanderbilt, 2200 Children's Way 5th Floor, Nashville, TN, 37232, USA.
University of Gondar · ETAddis Ababa University · ETMonroe Carell Jr. Children's Hospital · USThe Carter Center · ETVanderbilt Health · US

Funding

Developmental Determinants of Cardiovascular DiseaseT32HL105334 · NHLBI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BALDWIN, H SCOTT · 2011 to 2021
$4.3M
NHLBI NIH HHS T32 HL105334NIH HHS 5T32HL105334-09
6 · The paper itself

Abstract

backgroundEthiopia has a high acute rheumatic fever (ARF) and rheumatic heart disease (RHD) prevalence, and to our knowledge, there are no data on the status of secondary prevention in children with RHD. This study describes the status of secondary RHD prevention.

methodsA multicenter, prospective study was performed on children aged 5-17 years with RHD in Ethiopia. Good adherence was defined as at least 80% completion of benzathine penicillin (BPG) or oral Amoxicillin within the previous year. The primary outcome measure was adherence to prophylaxis, expressed as a proportion. Socio-demographics, severity of RHD, and ARF recurrence were evaluated.

resultsA total of 337 children with a mean age of 12.9 ± 2.6 years were included. The majority (73%) had severe aortic/mitral disease. Participants were on BPG (80%) or Amoxicillin (20%) prophylaxis. Female sex (P = 0.04) use of BPG (0.03) and shorter mean duration of prophylaxis in months (48.5 ± 31.5 vs. 60.7 ± 33, respectively, P < 0.008) predicted good adherence. Running out of medications (35%), interrupted follow-up (27%), and the COVID-19 pandemic (26%) were the most common reasons for missing prophylaxis. Recurrence of ARF was higher in participants on Amoxicillin compared with BPG (40% vs. 16%, P < 0.001) and in those with poor adherence compared with good adherence (36.8% vs. 17.9%, respectively, P = 0.005). Type and duration of prophylaxis (OR 0.5, CI = 0.24, 0.9, P = 0.02; OR = 1.1, CI = 1.1, 1.2, P = 0.04, respectively), and sex (OR = 1.9, CI = 1.1, 3.4, P = 0.03) were independent predictors of poor adherence.

conclusionPoor adherence is prevalent in Ethiopian children living with RHD. Amoxicillin is a suboptimal option for prophylaxis as its use is associated with lower adherence and a higher rate of ARF recurrence.

Indexed as

Secondary PreventionAdolescentAmoxicillinAnti-Bacterial AgentsChildChild, PreschoolEthiopiaFemaleHumansMaleMedication AdherencePenicillin G BenzathinePrevalenceProspective StudiesRecurrenceRheumatic Heart DiseaseAmoxicillinAnti-Bacterial AgentsPenicillin G BenzathineAdherenceARFProphylaxisRHD

Identifiers

PMID35109807
PMCPMC8809239
OpenAlexW4210366743

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.