Awareness of rheumatic heart disease prevention among primary health care providers and people aged nine years and above in Kinondoni municipality Dar es salaam, Tanzania.

Abstract

Background: Acute Rheumatic Fever (ARF) is an autoimmune consequence of infection with Group A 􀈕-haemolytic Streptococci (GAS). It causes an acute generalised inflammatory response and an illness that selectively affects the heart, joints, brain and skin. ARF leaves no lasting damage to the brain, joints or skin. However, damage to the heart valves, particularly the mitral and aortic valves, may persist after an acute episode has resolved. This involvement of the cardiac valves is known as Rheumatic Heart Disease (RHD), the most significant sequela of ARF. People who have had ARF previously are much more likely to have subsequent episodes, and these recurrences may cause further damage to the cardiac valves. Thus RHD steadily worsens in people who have multiple episodes of ARF. Early diagnosis and adequate treatment of GAS infection is an important initial stage in primary prevention of ARF as well as oral/IM penicillin for secondary prevention of ARF recurrent (secondary prevention of rheumatic fever). Despite significant morbidity caused by RHD, millions of people are unaware of having the disease and are not receiving secondary prevention. Broad Objective: To determine awareness of RHD prevention among primary health care workers, and the community (non health care workers aged 9 years and above) in Kinondoni municipality, Dar es salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted at Kinondoni municipality. The study population was adults and children aged 9 years and above (community) and primary health care workers at selected health centres and dispensaries at Kinondoni municipality. Data collection was done by using self administered questionnaire addressed to assess awareness of clinical presentations of acute rheumatic fever, primary and secondary prevention of rheumatic fever and rheumatic heart disease. Collected data were analysed using SPSS Version 15 Results The study recruited 740 people who were nine years and above, with their age range between 9 and 82, mean age 28.39(SD ± 13.96) years. Females were 375 (50.7%), M: F ratio was 1:1.03. Also recruited 540 primary health care workers, age range between 20 and 63 years, mean age 37.04(SD ± 8.603) years. Females 356 (65.9%)