Clinical Profile and Factors Related to Compliance with Benzathine Penicillin G Prophylaxis among RF/RHD Patients at the Tarlac Provincial Hospital, Philippines.
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Date
2015
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Abstract
Rheumatic fever (RF) and Rheumatic heart disease (RHD), despite a documented decrease in
their incidence, remain as problems in both industrialized and industrializing countries even at the
beginning of the 21st century. The most devastating effects are on children and young adults in
their most productive years.
To determine the clinical profiles of RF/RHD patients at Pediatric Department of Tarlac Provincial
Hospital, Tarlac city, Philippines and the factors related to their compliance with Benzathine
Penicillin G Prophylaxis treatment, the ex post-facto research was done using the charts of
patients. Out patients and ward patients diagnosed with RF/RHD patients were identified using the
Jones Criteria. They served as the subjects of the study. The onset of the RF/RHD was seen in age ranging from 6 years to 17 years old with most of them
occurring at 7-15 age range. The male to female ratio was 1.3:1. The RF/RHD patients came from
different towns of Tarlac, the most number of which came from the city of Tarlac. The patients,
being clientele of a provincial and non- paying hospital, came from poor family with low educational
attainment, and low monthly income from skilled or unskilled work. Carditis (55% of the 58 cases)
and polyarthritis (43%) were the most frequent manifestations seen among patients. In the minor
manifestations of RF, majority had episodes of acute tonsillopharyngitis (82%) and fever (82%).
Laboratory results, showed abnormal ESR (55 or 95% of the 58 cases), ASO titers (47 or 81%),
PR intervals (18 or 31%), and leukocytosis (30 or 67%). Of the 26 cases who had valvular
involvement cases, 7 mitral regurgitation; 2 (7%) had mitral stenosis; and 1 had aortic
regurgitation. The rest had combination or triple combinations of valvular involvement. Compliance
with Benzathine Penicillin G treatment was 46.6%. Compliance to treatment is related to the
occupation of father (x2= 6.643, significant at .0361 level) and family income (x2= 8.088, significant
at .0175 levels.
Poor families who have low paying jobs are less likely to complete the treatment of their sick
children. The Department of Health must find ways to provide the secondary chemoprophylaxis to
RF/RHD patients for free to improve the compliance rate, thus, provide bigger chance for the
RF/RHD patients to survive their disease.
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Keywords
Benzathine Penicillin G Prophylaxis, Rheumatic fever (RF) and Rheumatic heart disease (RHD), compliance, Tarlac Provincial Hospital
Citation
Respicio Rafael T, Sicat Lolita V. Clinical Profile and Factors Related to Compliance with Benzathine Penicillin G Prophylaxis among RF/RHD Patients at the Tarlac Provincial Hospital, Philippines. British Journal of Medicine and Medical Research. 2015; 6(7): 699-708.