A programme to increase appropriate usage of benzathine penicillin for management of streptococcal pharyngitis and rheumatic heart disease in Zambia

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 s...

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Bibliographic Details
Published in:Cardiovascular Journal of Africa 2017-07, Vol.28 (4), p.242-247
Main Authors: Fishman, Mark, Mayosi, Bongani M., Machila, Elizabeth, Musuku, John, Long, Aidan, Lungu, Joyce Chipili, Schwaninger, Sherri, Spector, Jonathan, Tadmor, Brigitta
Format: Article
Language:English
Subjects:
Allergies
Anaphylaxis
Antibiotics
Benzathine penicillin
Biomedical research
Cardiovascular disease
Cardiovascular Topics
Drug dosages
Education
Heart failure
Mortality
Pencillin allergy
Penicillin
Prevention
Rheumatic fever
Rheumatic heart disease
Teaching hospitals
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Summary: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.
ISSN:1995-1892
1680-0745
DOI:10.5830/CVJA-2017-002