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AFRICA
Cardiovascular Journal of Africa • ABSTRACTS – SA HEART
®
CONGRESS 2019
S46
Using visual and auditory tools in evaluating knowledge about rheumatic heart disease: The“Kick RHD out of Plateau”example
Christopher Yilgwan*, Olukemi Ige*, Santos Tanshak Larab*, Cornelius Gofung
#
, Fidelia Bode-Thomas*
*University of Jos, Jos, Nigeria.
#
Jos University Teaching Hospital, Jos, Nigeria.
Introduction:
Rheumatic heart disease has important public health implications for many communities in the developing world. Poor health literacy on the
determinants of the disease has been one of the main drivers of the problem. We evaluated the health knowledge of lay people in a Nigerian community
using visual and auditory tools to identify gaps in knowledge, attitude and practice.
Methods:
This was a qualitative study that evaluated the health literacy of 103 people living in suburban communities in Jos, Nigeria. An assessment
questionnaire was used to investigate their health literacy knowledge, attitudes and practices regarding sore throat, rheumatic fever and rheumatic heart
disease before, and after, administering the educational chart, or jingle, in a local language (Hausa). The pre- and post-test results were then computed for each
individual and the mean change in scores calculated using the paired t-test. SPSS version 23 was used for all statistics. Significance testing was set at p=0.05.
Results:
Sixty-three percent of the respondents were females while the mean age was 47.6 ± 19.2 years. The mean pre-test score was 2.78 on a
scale of 10 for the visual tool while the mean post-test score was 4.90 (r=0.3, p=0.04). For the auditory tool (jingles), the mean pre-test score was
3.3, while the mean post-test score was 5.2 (r=0.45, p=0.002). The mean change in score was 2.1 ± 2.8 (95% CI 1.4 - 2.9, p<0.001) for the visual tool and
1.8 ± 2.2 (95% CI 3.3 - 5.2, p=0.01) for the jingle.
Conclusion:
Both tools significantly improved baseline knowledge about rheumatic heart diseases in a lay community. The poster, however, appears to have
had a greater effect.
Response to the Addis Ababa communiqué on the eradication of rheumatic heart disease in Africa: A progress update from
the PASCAR RHD task force
Liesl Zühlke*, Mark Engel, Ana Olga Mocumbi
†
, Sulafa Ali
‡
, Ashmeg Abdulla
◊
, Christopher Hugo-Hamman
§
, David Watkins
∆
and Saad Subahi
+
, **
*Children’s Heart Disease Research Unit (CHDRU), Department of Paediatrics, Red Cross War Memorial Children’s Hospital, University of Cape Town,
Observatory, South Africa.
#
Department of Medicine, University of Cape Town, Rondebosch, South Africa.
†
Instituto Nacional de Saúde, Mozambique and
PASCAR Vice South Africa.
‡
University of Khartoum and Sudan Heart Centre, Khartoum, Sudan.
◊
King-Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
§
Ministry of Health and Social Services, Windhoek, Namibia.
∆
University of Washington, Washington, United States of America.
+
Ribat University Hospital,
Khartoum, Sudan. **College of Medicine, Alribat National University, Khartoum, Sudan
Introduction:
There are an estimated 33.4 million people living with rheumatic heart disease (RHD) globally, most of these reside in Africa. Although the
condition has almost been eradicated in the global North, RHD persists as a significant public health concern in countries with high levels of poverty, socio-
economic disparity and poor access to healthcare services. Existing research evidence compels us to take immediate action with regards to RHD control in
Africa. Seven priority areas for action to eradicate RHD in Africa were identified at the 4th All-Africa Workshop on Acute Rheumatic Fever and Rheumatic Heart
Disease (2016).
Methods:
After these recommendations were endorsed and officially adopted by the African Union Commission (AUC) in the Addis Ababa communiqué,
7 action groups were launched with a mandate to develop principles for implementing RHD prevention and control programmes. We report the overall
progress of these, highlighting the activities of each action group towards achieving specific objectives at country level.
Results:
Through the action groups, the taskforce has successfully: (1) launched several RHD research projects across Africa, (2) developed data collection
tools, e.g. the RHD Patient Management Tool to enable data capturing and routine patient management on a single platform, (3) conducted situational
analyses which have highlighted important gaps in the availability of oral penicillin and BPG as well as barriers to proper administration in African countries,
(4) developed and published resources such as the taskforce position paper to guide health professionals on sexual and reproductive health in women with
RHD and various other training resources for health workers and (5) provided grant support for advocacy activity focused on integrated multi-sectoral RHD
prevention programmes across Africa.
Conclusion:
We demonstrate the PASCAR RHD task force’s progress but stress the importance of continued advocacy efforts and political will to prioritise
RHD prevention and control in Africa.
Lessons from the Adolescents Receiving Continuous Care for Childhood-Onset Chronic Conditions (ADOLE7C) study:
Transition of overage patients at a paediatric cardiology outpatient clinic
Liesl Zühlke*,
#
, Alexia Joachim*, Eloise Hendricks
#
, Cameron Hendricks*, John Lawrenson*, Blanche Cupido
#
, Ewa-Lena Bratt
†
,
‡
,
Bongani Mayosi
◊
, ** and Philip Moons*,
§
*Children’s Heart Disease Research Unit (CHDRU), Department of Paediatrics, Red Cross War Memorial Children’s Hospital, University of Cape Town,
Observatory, South Africa.
#
Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory.
†
Institute
of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
‡
Department of Paediatric Cardiology, The Queen
Silvia Children’s Hospital, Gothenburg, Gothenburg. Sweden.
◊
,**The Deanery, Faculty of Health Sciences, University of Cape Town, Groote Schuur Hospital,
Observatory, South Africa.
§
Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium. **Deceased
Introduction:
As part of the study, we aimed to identify over-age patients (>13 years) still in the care of the outpatient paediatric cardiac clinic, to
thus review their clinical status and map their transfer and transition plans.
Methods:
We identified all over-age patients in the outpatient cardiology service at Red Cross Hospital. Patients attend a designated adolescent clinic at
which time they were reviewed for transitional care (preparation for transfer) or readiness for transfer to the grown-up congenital heart disease (GUCH) clinic.
Results:
In the period 2017 to present, over 30% (n=343) of our outpatient paediatric cardiology service dealt with over-age patients whose ages ranged
from 13 - 28 years. After a detailed review of each patient, patients were assigned in the following ways: 42% were still within the paediatric cardiology service,
22% were now formally transferred, 14% had been formally discharged, 2% were in shared care with the palliative service and 3% had died. Of note compared
to patients born in 1991 - 1994, only 17% were lost to follow-up compared to over 80% previously recorded
Conclusion:
As much as 30% of the patients attending our clinic was over-age. Transfer is viewed as a transitional process which includes preparation, review
of clinical findings and then only transfer. Although only 22% of the patients have subsequently been transferred, we have instituted formal discharges and
shared care which will improve outcomes for these patients.