Knowledge of Acute Rheumatic Fever and Rheumatic Heart Disease Prevention Among House Officers in Three Teaching Hospitals, Khartoum, Sudan

苏丹喀土穆三家教学医院住院医师对急性风湿热和风湿性心脏病预防知识的掌握情况

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Abstract

BACKGROUND: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of cardiovascular morbidity and mortality in Sudan. House officers are often the first point of contact in hospitals, making their knowledge critical for effective prevention. This study assessed the knowledge of house officers regarding the prevention of ARF and RHD. METHODS: A cross-sectional study was conducted from October 2017 to February 2018 at three major teaching hospitals (Omdurman, Bahri, and Ibrahim Malik) in Khartoum. A sample of 186 house officers was recruited. Data were collected using a self-administered questionnaire to assess knowledge of Group A streptococcal (GAS) pharyngitis diagnosis, ARF diagnosis using the 2015 Jones criteria, and primary and secondary prevention strategies. Data were analyzed using SPSS version 20 (IBM Corp., Armonk, NY). RESULTS: The response rate was 100% (186 participants), comprising 47.3% males and 52.7% females. Knowledge of the clinical diagnosis of GAS pharyngitis per national guidelines was low (30%). Knowledge of the first-line drug for treatment was 44%, while awareness of the second-line drug was higher (64%). The understanding of ARF diagnosis for a new case was 68.8%, but only 43.5% for a recurrent case. Knowledge of primary prevention was 79%, while secondary prevention was 53.8%. Awareness of the correct duration of secondary prophylaxis was 30% for cases without carditis and 55.9% for cases with carditis. Overall, 17.7% of participants had poor knowledge (≤31% correct answers), 64% had average knowledge (37%-69% correct), and 17.7% had sufficient knowledge (≥75% correct). CONCLUSION: The overall knowledge of house officers regarding ARF and RHD prevention was average. Significant gaps were identified in the diagnosis of GAS pharyngitis, management of recurrent ARF, and protocols for secondary prophylaxis. Targeted educational interventions are urgently needed to improve adherence to national guidelines.

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