Early Implementation and Clinical Outcomes of an Integrated Rheumatic Heart Disease Screening and Treatment Program in Northern Uganda.
| Title: | Early Implementation and Clinical Outcomes of an Integrated Rheumatic Heart Disease Screening and Treatment Program in Northern Uganda. |
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| Authors: | Pulle J; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Kayima J; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Zhang N; Division of Biostatistics & Epidemiology, Cincinnati Children's Hospital Medical Centre, OH (N.Z.).; University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).; Danforth K; Department of Global Health, University of Washington, Seattle. (K.D., C.T.L., K.S., M.P., D.A.W.).; Webel AR; Department of Child, Family & Population Health Nursing (A.R.W.), University of Washington, Seattle.; Oyoo CA; Ministry of Health, Kampala, Uganda (C.A.O.).; Longenecker CT; Department of Global Health, University of Washington, Seattle. (K.D., C.T.L., K.S., M.P., D.A.W.).; Sable C; Ochsner Children's Hospital, New Orleans, LA (C.S.).; Nakagaayi D; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Ayaa E; Department of Health, Kitgum District, Uganda (E.A.).; Odong F; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Otim IO; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Rwebembera J; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Sherr K; Department of Global Health, University of Washington, Seattle. (K.D., C.T.L., K.S., M.P., D.A.W.).; Pardo M; Department of Global Health, University of Washington, Seattle. (K.D., C.T.L., K.S., M.P., D.A.W.).; Heart Institute, Cincinnati Children's Hospital Medical Center, OH (M.P., S.L., S.H.W., A.B.).; Atukunda M; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Sarnacki R; Children's National Medical Center, Washington, DC (R.S.).; Ogwanh R; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; deLoizaga S; University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).; Heart Institute, Cincinnati Children's Hospital Medical Center, OH (M.P., S.L., S.H.W., A.B.).; Wirth SH; University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).; Heart Institute, Cincinnati Children's Hospital Medical Center, OH (M.P., S.L., S.H.W., A.B.).; Sewankambo NK; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Okello E; Uganda Heart Institute, Kampala (J.P., J.K., D.N., F.O., I.O.O., J.R., M.A., R.O., E.O.).; Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda (J.P., J.K., D.N., J.R., N.K.S., E.O.).; Beaton A; University of Cincinnati, College of Medicine, OH (N.Z., S.L., S.H.W., A.B.).; Heart Institute, Cincinnati Children's Hospital Medical Center, OH (M.P., S.L., S.H.W., A.B.).; Watkins DA; Department of Global Health, University of Washington, Seattle. (K.D., C.T.L., K.S., M.P., D.A.W.).; Department of Medicine (D.A.W.), University of Washington, Seattle. |
| Source: | Circulation. Population health and outcomes [Circ Popul Health Outcomes] 2026 May 01, pp. e012831. Date of Electronic Publication: 2026 May 01. |
| Publication Model: | Ahead of Print |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Country of Publication: United States NLM ID: 9919227857106676 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 3068-563X (Electronic) Linking ISSN: 3068563X NLM ISO Abbreviation: Circ Popul Health Outcomes Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Wolters Kluwer ; American Heart Association, 2026- |
| Abstract: | Background: The World Health Organization recommends echocardiographic screening and secondary prophylaxis for rheumatic heart disease (RHD), but evidence on how to implement these interventions within healthcare systems is limited. We report early implementation and clinical outcomes of an RHD program in northern Uganda.; Methods: From May 2023, the District Health Office in Kitgum trained primary healthcare workers in RHD screening and implemented registry-based secondary antibiotic prophylaxis in public facilities. We analyzed program and registry data through December 31, 2024. Data were obtained from aggregated program reports and individual-level records from the national RHD registry. We developed an RHD care cascade to examine screening uptake and outcomes, including adherence to secondary antibiotic prophylaxis. Adherence was categorized as perfect (100%), near perfect (90%-99%), acceptable (80%-89%), suboptimal (60% to 79%), or poor ( |
| Grant Information: | D43 TW012255 United States TW FIC NIH HHS; R01 HL164615 United States HL NHLBI NIH HHS |
| Contributed Indexing: | Keywords: Uganda; antibiotic prophylaxis; continuity of patient care; public facilities; rheumatic heart disease |
| Entry Date(s): | Date Created: 20260501 Latest Revision: 20260505 |
| Update Code: | 20260505 |
| PubMed Central ID: | PMC13138436 |
| DOI: | 10.1161/CIRCOUTCOMES.125.012831 |
| PMID: | 42065124 |
| Database: | MEDLINE |
Journal Article