Cardiovascular Journal of Africa: Vol 28 No 4 (July/August 2017)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 28, No 4, July/August 2017 246 AFRICA
This position is supported by several large published studies
that evaluated interventions with BPG in RHD patients, where
large numbers of BPG injections were administered without
prior penicillin-allergy testing,33,34 and reported the incidence of
adverse reactions, including anaphylaxis, was exceedingly low.36
A key action recommended in the plan to eradicate RHD in
Africa includes appropriate training of health workers to safely
and effectively deliver BPG.22 The preliminary experience in
Zambia suggests that appropriate educational interventions in
the setting of drug availability and ready access to medications
to treat anaphylaxis can positively impact on rates of BPG
usage. Future work will involve the exploration of innovative
ways to scale up the RHD control programme, such as the use
of electronic training modules, and determination of the impact
of these types of interventions on health outcomes, including the
incidence of RF and RHD.
Conclusion
A multi-faceted effort to combat RHD in Zambia included, as a
core component, a novel programme to demystify concerns and
dispel fears about safe administration of BPG. It appears that
this approach contributed to increases in the rate of BPG use
for primary and secondary prevention of RHD in government
health facilities, according to national guidelines. Lessons from
this experience may be applicable to other countries where RHD
is endemic.
SS, JS, BT and MF are or were employees of Novartis Institutes for
BioMedical Research, which is a corporate affiliate of Sandoz. JM receives
grant funding from NIBR.
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