In one paragraphArticle in Circulation. Population health and outcomes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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0citing papers in PubMed
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What it found
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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 registryThe 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.
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3 · Its place in the literatureWho cites it
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4 · The recordCorrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
5 · Who and what moneyAuthors and funding
24 authors.
Jafesi PulleRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0001-7955-3481 James KayimaRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).
Nanhua ZhangDivision of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Centre, OH (N.Z.).ORCID 0000-0001-5796-3404 Kristen DanforthDepartment of Global Health (K.D., C.T.L., K.S., M.P., D.W.), University of Washington, Seattle.ORCID 0000-0002-7409-6661 Allison R WebelDepartment of Child, Family & Population Health Nursing (A.R.W.), University of Washington, Seattle.
Charles A OyooDepartment of Non-Communicable Diseases, Ministry of Health, Kampala, Uganda (C.A.O.).ORCID 0009-0007-8515-0196 Chris T LongeneckerDepartment of Global Health (K.D., C.T.L., K.S., M.P., D.W.), University of Washington, Seattle.ORCID 0000-0002-9468-0179 Doreen NakagaayiRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0003-4010-9951 Evaline AyaaDepartment of Health, Kitgum District, Uganda (E.A.).
Francis OdongRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).
Isaac O OtimRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0003-0524-0364 Joselyn RwebemberaRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0001-8453-818X Kenneth SherrDepartment of Global Health (K.D., C.T.L., K.S., M.P., D.W.), University of Washington, Seattle.ORCID 0000-0002-2963-0829 Michaela PardoDepartment of Global Health (K.D., C.T.L., K.S., M.P., D.W.), University of Washington, Seattle.ORCID 0009-0000-3819-8567 Mucunguzi AtukundaRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0003-4762-0728 Ronald OgwanhRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).
Sarah deLoizagaDepartment of Pediatrics, University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).ORCID 0000-0002-1001-273X Scott H WirthDepartment of Pediatrics, University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).ORCID 0000-0003-3901-2669 Nelson K SewankamboDepartment of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).ORCID 0000-0001-9362-053X Emmy OkelloRheumatic Heart Disease Research Collaborative, Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).ORCID 0000-0002-6109-0092 Andrea BeatonDepartment of Pediatrics, University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).ORCID 0000-0002-4963-355X David WatkinsDepartment of Global Health (K.D., C.T.L., K.S., M.P., D.W.), University of Washington, Seattle.ORCID 0000-0001-6341-9595 Funding
Accelerating Delivery of rheumatic heart disease preventive iNterventions in Uganda (ADUNU)R01HL164615 · NHLBI · CINCINNATI CHILDRENS HOSP MED CTR · PI Andrea Zawacki Beaton, David A Watkins · 2022 to 2026
$3.0MReducing the Impact of Rheumatic Heart Disease across the Life Span: The Impact ProgramD43TW012255 · FIC · MAKERERE UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI Andrea Zawacki Beaton, Emmy Okello · 2022 to 2026
$1.1MFIC NIH HHS D43 TW012255NHLBI NIH HHS R01 HL164615
6 · The paper itselfAbstract
backgroundThe World Health Organization recommends echocardiographic screening and secondary prophylaxis for rheumatic heart disease (RHD), but evidence on how to implement these interventions within healthcare systems is limited. We report early implementation and clinical outcomes of an RHD program in northern Uganda.
methodsFrom May 2023, the District Health Office in Kitgum trained primary healthcare workers in RHD screening and implemented registry-based secondary antibiotic prophylaxis in public facilities. We analyzed program and registry data through December 31, 2024. Data were obtained from aggregated program reports and individual-level records from the national RHD registry. We developed an RHD care cascade to examine screening uptake and outcomes, including adherence to secondary antibiotic prophylaxis. Adherence was categorized as perfect (100%), near perfect (90%-99%), acceptable (80%-89%), suboptimal (60% to 79%), or poor (<60%). Differences in mean adherence across subgroups were evaluated using 1-way ANOVA and χ
resultsHealth workers screened about 1% of the district's target population each month. Over 18 months, 25 358 people were screened, including 1213 (4.8%) positive screens and 333 (1.3%) confirmed RHD cases. Among those screened, 16 406 (64%) were female, and 10 746 (42%) and 7333 (28%) were children (aged 5 years-14 years) and adolescents (aged 15 years-24 years), respectively. Of those with positive screens, 972 (80%) received confirmatory echocardiograms. Confirmed cases were relatively young (mean age 28 years), and 224 (67%) were female. Overall, 220 (75%) individuals achieved at least acceptable adherence. Among those who defaulted, 79% did so within 6 months of enrollment.
conclusionsAn integrated RHD program in Uganda achieved successful delivery of echocardiographic screening within primary healthcare and acceptable early outcomes. The care cascade framework can be used to monitor similar RHD programs and identify opportunities for improvement.
Indexed as
Antibiotic ProphylaxisMass ScreeningRheumatic Heart DiseaseAdolescentAdultChildEchocardiographyFemaleHumansMaleMiddle AgedRegistriesUgandaantibiotic prophylaxiscontinuity of patient caredelivery of healthcarehealth facilitiesrheumatic heart diseaseUganda
Identifiers
PMID42065124
PMCPMC13138436
What OpenQuestion holds
Textmetadata
LicenceCC BY-NC-ND
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