Poster Presentation 20th Lancefield International Symposium on Streptococci and Streptococcal Diseases 2017

Innovations In Delivery Of Secondary Prophylaxis Treatment For People Living With RHD In Fiji Islands   (#224)

Elizabeth Kennedy 1 , Emele Naiceru 1 , Ana Ramaka 1 , Laisiana Matatolu 1 , Maciu Silai 1 , Sainimere Boladuadua 1 , Maureen Ah Kee 1 , Frances Matanatabu 1 , Samantha Colquhoun 2 , Joseph Kado 3
  1. Fiji Rheumatic Heart Disease Control Program, Fiji Ministry of Health & Medical Services, Suva,Toorak, Republic of the Fiji Islands
  2. Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
  3. College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Republic of the Fiji Islands

Rheumatic Heart Disease (RHD) is a significant public health problem in Fiji. Episodes of acute rheumatic fever (ARF) are often unrecognised and cases of RHD often present in severe stages.

The Fiji RHD Prevention and Control Project is delivering a four year activity led by Fiji Ministry of Health and Medical Services. The Project has implemented multiple interventions aimed at improving adherence by 1) improving knowledge of the disease and support to patients and carers 2) training of health professionals on importance of secondary prophylaxis treatment and patient counselling.

The Project has piloted models of care at eleven health facilities across Fiji. Patient/carer interviews were conducted in the design and interim phases. The effectiveness of interventions were evaluated via the rheumatic fever information system which records Benzathine penicillin adherence data. Data were gathered and analysed for training, media campaign and support activities. Patient support groups were led by nurses using educational flip charts followed by open discussion.     

The Project has reached over 700 patients and carers through support group activities. Approximately 40% of the nurse workforce were trained in ARF/RHD. Preliminary data is showing an average 20% improvement in adherence among patients at pilot sites over an 18 month period and a multi-media campaign promoting Benzathine adherence was implemented in 2017.             

The Project, has potential to contribute substantially to the development of a model of chronic disease care in Fiji with experience that can be applied in other high RHD prevalence (and high NCD) countries.