Objective: While mostly eradicated in developed nations, rheumatic heart disease (RHD), is still the leading cause of preventable cardiovascular disease in children. RHD and its antecedent acute rheumatic fever (ARF) remain endemic in many low to middle income countries, as well as in vulnerable communities in wealthy ones. Evidence-based interventions are particularly important in resource-poor settings. We sought to determine if efforts directed at patient and family education impact compliance with community based prevention measures, and with short term disease progression.
Materials and methods: We performed an observational, cross-sectional study of children with RHD aged 5-19 years, along with their parents, in American Samoa. A survey was administered in November 2016 to assess patient and parent knowledge of RHD. Scores were compared to compliance with penicillin prophylaxis via chart review.
Results: We collected a total of 70 surveys of child-parent dyads with a patient mean age of 14.28 years ± 2.71. An increased knowledge score was predictive of increased penicillin compliance for both children (12.70% increase in compliance per 1-unit increase in score (p=0.0004)) and parents (10.10% increase in compliance per 1-unit increase in score (p=0.0012)).
Discussion: Increased knowledge about RHD, and particularly treatment of RHD, was correlated with increased compliance with secondary penicillin prophylaxis. With a 12.7% increase in compliance for every 1-unit increase in the child’s overall survey score and a 9.4% increase for every 1-unit increase in the parent-child combined overall score.
Conclusion: A clear relationship exists between patient and parent knowledge of rheumatic heart disease and compliance with penicillin prophylaxis. This study was the first to link patient understanding of RHD to compliance with preventative measures.
Rheumatic heart disease, patient education, pediatric cardiology