A programme to increase appropriate usage of benzathine penicillin for management of streptococcal pharyngitis and rheumatic heart disease in Zambia
نویسندگان
چکیده
Rheumatic heart disease is highly prevalent and associated with substantial morbidity and mortality in many resource-poor areas of the world, including sub-Saharan Africa. Primary and secondary prophylaxis with penicillin has been shown to significantly improve outcomes and is recognised to be the standard of care, with intra-muscular benzathine penicillin G recommended as the preferred agent by many technical experts. However, ensuring compliance with therapy has proven to be challenging. As part of a public-private partnership initiative in Zambia, we conducted an educational and access-to-medicine programme aimed at increasing appropriate use of benzathine penicillin for the prevention and management of rheumatic heart disease, according to national guidelines. The programme was informed early on by identification of potential barriers to the administration of injectable penicillin, which included concern by health workers about allergic events. We describe this programme and report initial signs of success, as indicated by increased use of benzathine penicillin. We propose that a similar approach may have benefits in rheumatic heart disease programmes in other endemic regions.
منابع مشابه
Microbiological diagnosis of streptococcal pharyngitis: lacunae and their implications.
Post-streptococcal sequelae, especially acute rheumatic fever/rheumatic heart disease continue to occur in significant proportions in many parts of the world. Despite several attempts with various intervention strategies, little success has been achieved in the control of acute rheumatic fever/rheumatic heart disease in India. The success of the control programmes depends upon timely primary pr...
متن کاملConsensus guidelines on pediatric acute rheumatic fever and rheumatic heart disease.
JUSTIFICATION Acute rheumatic fever and rheumatic chronic valvular heart disease is an important preventable cause of morbidity and mortality in suburban and rural India. Its diagnosis is based on clinical criteria. These criteria need verification and revision in the Indian context. Furthermore, there are glaring differences in management protocols available in literature. These facts prompted...
متن کاملGroup A Streptococcus, Acute Rheumatic Fever and Rheumatic Heart Disease: Epidemiology and Clinical Considerations
OPINION STATEMENT Early recognition of group A streptococcal pharyngitis and appropriate management with benzathine penicillin using local clinical prediction rules together with validated rapi-strep testing when available should be incorporated in primary health care. A directed approach to the differential diagnosis of acute rheumatic fever now includes the concept of low-risk versus medium-t...
متن کاملStreptococcal Pharyngitis: A Scientific Statement From the American Heart Prevention of Rheumatic Fever and Diagnosis and Treatment of Acute
Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A -hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by combining clinical judgment with diagnostic test results, the criterion standard of which is the throat culture. Penicillin (either oral penicillin V or injectabl...
متن کاملSupply of benzathine penicillin G: the 20-year experience in Australia.
Australian and New Zealand Journal of Public Health 1 © 2015 Public Health Association of Australia Benzathine benzylpenicillin G (BPG) is a beta-lactamase antibiotic developed in 1951.1 Administered intramuscularly, BPG has low in vivo solubility, producing prolonged serum penicillin concentrations. This makes BPG suitable for treating penicillin-sensitive organisms responsive to extended, low...
متن کامل