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在喀麦隆开办首个风湿性心脏病诊所:一项描述性研究。

Initiating the first rheumatic heart disease clinic in Cameroon: A descriptive study.

作者信息

Njedock Nelson, Yanwou Nathan, Wotol Maxime, Shu Beckly, Azanfack Raisa, Nkoke Clovis, Chelo David

机构信息

Faculty of Medicine and Biomedical Sciences University of Yaoundé 1 Yaoundé Cameroon.

Friendly Heart Yaounde Cameroon.

出版信息

Health Sci Rep. 2023 Jul 28;6(8):e1446. doi: 10.1002/hsr2.1446. eCollection 2023 Aug.

Abstract

BACKGROUND AND AIM

Rheumatic heart disease (RHD) is a significant cause of heart failure in sub-Saharan Africa. The causes of death from RHD are multiple, many of which can be prevented with appropriate follow-up of patients and effective secondary prophylaxis. An RHD Clinic was initiated to attempt a solution in Yaoundé, Cameroon. Over 6 months, its impact was evaluated.

METHODS

Two echocardiography registers were accessed, and patients diagnosed with RHD between 2005 and 2018 were contacted. Consenting carers and patients pioneered the first RHD Clinic. Activities of the clinic comprised health education, medical visits, and benzylpenicillin G (BPG) injections. Text messages and phone calls were used to remind patients of their monthly appointments.

RESULTS

Out of 1200 first-time cardiac ethnographies, 70 patients (5.83%) had been diagnosed with RHD. The case fatality rate of RHD was 16.67%. Twenty-three patients were successfully registered and followed-up by the clinic, 70% of whom were female. The age range was 4-22 years. Fifty-three percent had an NYHA score of 2 or more at the time of admission into the clinic. There was an increase in adherence to secondary prophylaxis with BPG from 42.9% at baseline to 87%-95% in the last 3 months.

CONCLUSION

Our short experience running an RHD Clinic was marked by increased treatment adherence among persons living with RHC.

摘要

背景与目的

风湿性心脏病(RHD)是撒哈拉以南非洲地区心力衰竭的一个重要病因。RHD导致死亡的原因是多方面的,其中许多通过对患者进行适当随访和有效的二级预防是可以预防的。在喀麦隆雅温得启动了一家RHD诊所来尝试解决这一问题。在6个多月的时间里,对其影响进行了评估。

方法

查阅了两份超声心动图登记资料,并联系了2005年至2018年间被诊断为RHD的患者。同意参与的护理人员和患者率先参与了第一家RHD诊所。该诊所的活动包括健康教育、医疗问诊和苄星青霉素G(BPG)注射。通过短信和电话提醒患者每月的预约。

结果

在1200份首次心脏检查记录中,70例患者(5.83%)被诊断为RHD。RHD的病死率为16.67%。23例患者成功在该诊所登记并接受随访,其中70%为女性。年龄范围为4至22岁。53%的患者在进入诊所时纽约心脏协会(NYHA)心功能分级为2级或更高。接受BPG二级预防的依从性从基线时的42.9%增加到最后3个月的87%-95%。

结论

我们运营RHD诊所的短暂经验的特点是RHD患者的治疗依从性有所提高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ab1/10375454/4856bb32b0fb/HSR2-6-e1446-g003.jpg

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