Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
Determinants of poor adherence to secondary antibiotic prophylaxis for rheumatic fever recurrence on Lifou, New Caledonia: a retrospective cohort study.
[acute rheumatic fever]
Incidence
of
acute
rheumatic
fever
(
ARF
)
and
prevalence
of
rheumatic
heart
disease
(
RHD
)
in
the
Pacific
region
,
including
New
Caledonia
,
are
amongst
the
highest
in
the
world
.
The
main
priority
of
long
-term
management
of
ARF
or
RHD
is
to
ensure
secondary
prophylaxis
is
adhered
to
.
The
objectives
of
this
study
were
to
evaluate
rates
of
adherence
in
people
receiving
antibiotic
prophylaxis
by
intramuscular
injections
of
penicillin
in
Lifou
and
to
determine
the
factors
associated
with
a
poor
adherence
in
this
population
.
We
conducted
a
retrospective
cohort
study
and
we
included
70
patients
receiving
injections
of
antibiotic
prophylaxis
to
prevent
ARF
recurrence
on
the
island
of
Lifou
.
Patients
were
classified
as
"
good-adherent
"
when
the
rate
of
adherence
was
≥
80
%
of
the
expected
injections
and
as
"
poor
-adherent
"
when
it
was
<
80
%
.
Statistical
analysis
to
identify
factors
associated
with
adherence
was
performed
using
a
multivariate
logistic
regression
model
.
Our
study
showed
that
46
%
of
patients
from
Lifou
receiving
antibiotic
prophylaxis
for
ARF
or
RHD
had
a
rate
of
adherence
<
80
%
and
were
therefore
at
high
risk
of
recurrence
of
ARF
.
Three
independent
factors
were
protective
against
poor
adherence
:
a
household
with
more
than
five
people
(
odds
ratio
,
0
.
25
;
95
%
confidence
interval
[
CI
]
,
0
.
08
to
0
.
75
)
,
a
previous
medical
history
of
symptomatic
ARF
(
odds
ratio
,
0
.
20
;
95
%
CI
,
0
.
04
to
0
.
98
)
and
an
adequate
healthcare
coverage
(
odds
ratio
,
0
.
21
;
95
%
CI
0
.
06
to
0
.
72
)
.
To
improve
adherence
to
secondary
prophylaxis
in
Lifou
,
we
therefore
propose
the
following
recommendations
arising
from
the
results
of
this
study
:
i
)
identifying
patients
receiving
antibiotic
prophylaxis
without
medical
history
of
ARF
to
strengthen
their
therapeutic
education
and
ii
)
improving
the
medical
coverage
in
patients
with
ARF
or
RHD
.
We
also
recommend
that
the
nurse
designated
for
the
ARF
prevention
program
in
Lifou
coordinate
an
active
recall
system
based
on
an
updated
local
register
.
But
the
key
point
to
improve
adherence
among
Melanesian
patients
is
probably
to
give
appropriate
information
regarding
the
disease
and
the
treatment
,
taking
into
account
the
Melanesian
perceptions
of
the
disease
.
Diseases
Validation
Diseases presenting
"long-term management"
symptom
acute rheumatic fever
allergic bronchopulmonary aspergillosis
congenital adrenal hyperplasia
You can validate or delete this automatically detected symptom
Validate the Symptom
Delete the Symptom
