PMID- 32963968
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 2214-9996 (Electronic)
IS  - 2214-9996 (Linking)
VI  - 86
IP  - 1
DP  - 2020 Sep 9
TI  - Postoperative Rheumatic Heart Disease Follow-Up: Creating a National Registry and 
      First Results from Rwanda.
PG  - 115
LID - 10.5334/aogh.2719 [doi]
LID - 115
AB  - BACKGROUND: In many developing countries, rheumatic heart disease (RHD) is 
      diagnosed at an advanced stage and requires surgery for patient survival. 
      However, access to cardiac surgery in this context is limited and often provided 
      through partnerships, requiring centralized patient data systems for monitoring 
      and follow-up. OBJECTIVES: This study used data from a national postoperative RHD 
      registry to analyze clinical outcomes of Rwandan patients who received surgery 
      between 2006 and 2017. METHODS: The RHD registry was created in 2017 using data 
      compiled from Rwanda Ministry of Health and RHD surgery partners. We extracted 
      pre- and post-operative data on patients who were alive and in care. We excluded 
      patients who died or were lost to follow-up, as their data was not collected in 
      the registry. We evaluated the association between demographic, surgical, and 
      follow-up characteristics and most recent patient symptoms, categorized by New 
      York Heart Association (NYHA) class. FINDINGS: Among the 191 patients eligible 
      for inclusion in this study, 107(56.0%) were female, 110(57.6%) were adults at 
      the time of surgery (>15 years), and 128(67.4%) had surgery in Rwanda. Most 
      patients (n = 166, 86.9%) were on penicillin prophylaxis. Of the patients with 
      mechanical valves, 47(29.9%) had therapeutic International Normalized Ratio 
      values. 90% of patients were asymptomatic (NYHA I) at the time of most recent 
      visit. NYHA class was not significantly associated with any of the considered 
      variables. The median length of follow-up for patients was four years (IQR: 2, 5 
      years). CONCLUSION: This study shows both the feasibility and challenges of 
      creating a RHD registry 11 years after the national initiation of RHD surgeries. 
      Most patients captured in the registry are asymptomatic; however, collecting 
      details on patients who had died or were lost to follow-up has proven difficult. 
      Implementing strategies to maintain a complete and up-to-date registry will 
      facilitate follow-up for pre- and postoperative patients.
CI  - Copyright: (c) 2020 The Author(s).
FAU - Ntaganda, Evariste
AU  - Ntaganda E
AD  - Rwanda Biomedical Center, Kigali, RW.
FAU - Rusingiza, Emmanuel
AU  - Rusingiza E
AD  - University of Rwanda, College of Medicine and Health Sciences, Kigali, RW.
FAU - Rukundo, Gilbert
AU  - Rukundo G
AD  - Partners In Health, Inshuti Mu Buzima, Kigali, RW.
FAU - Ng'ang'a, Loise
AU  - Ng'ang'a L
AD  - Partners In Health, Inshuti Mu Buzima, Kigali, RW.
FAU - Hedt-Gauthier, Bethany
AU  - Hedt-Gauthier B
AD  - Partners In Health, Inshuti Mu Buzima, Kigali, RW.
AD  - Department of Global Health and Social Medicine, Harvard Medical School, Boston, 
      US.
FAU - El-Khatib, Ziad
AU  - El-Khatib Z
AD  - University School of Medicine, Boston, US.
AD  - Karolinska Institutet, Stockholm, SE.
FAU - Kwan, Gene F
AU  - Kwan GF
AD  - Department of Global Health and Social Medicine, Harvard Medical School, Boston, 
      US.
AD  - University School of Medicine, Boston, US.
FAU - Gapira, Ganza
AU  - Gapira G
AD  - Rwanda Military Hospital, Kigali, RW.
FAU - Worrall, Neil K
AU  - Worrall NK
AD  - Healing Hearts Northwest, RW.
FAU - Swain, JaBaris
AU  - Swain J
AD  - Team Heart, Inc, RW.
FAU - Kagame, Abel
AU  - Kagame A
AD  - Rwanda Heart Foundation, RW.
FAU - Mutumbira, Cadet
AU  - Mutumbira C
AD  - Rwanda Biomedical Center, Kigali, RW.
FAU - Ruhamya, Nathan
AU  - Ruhamya N
AD  - King Faisal Hospital, Kigali, RW.
FAU - Bolman, Ceeya
AU  - Bolman C
AD  - Team Heart, Inc, RW.
FAU - Sewase, Jessica
AU  - Sewase J
AD  - Team Heart, Inc, RW.
FAU - Ndayisaba, Gilles
AU  - Ndayisaba G
AD  - Rwanda Biomedical Center, Kigali, RW.
FAU - Bolman Iii, R Morton
AU  - Bolman Iii RM
AD  - Team Heart, Inc, RW.
FAU - Goldberg, Harold
AU  - Goldberg H
AD  - Healing Hearts Northwest, RW.
FAU - Mucumbitsi, Joseph
AU  - Mucumbitsi J
AD  - Rwanda Heart Foundation, RW.
AD  - King Faisal Hospital, Kigali, RW.
LA  - eng
GR  - K23 HL140133/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200909
PL  - United States
TA  - Ann Glob Health
JT  - Annals of global health
JID - 101620864
SB  - IM
MH  - *Cardiac Surgical Procedures
MH  - Female
MH  - Humans
MH  - Registries
MH  - *Rheumatic Heart Disease/epidemiology/surgery
MH  - Rwanda/epidemiology
PMC - PMC7485403
COIS- The authors have no competing interests to declare.
EDAT- 2020/09/24 06:00
MHDA- 2021/10/16 06:00
PMCR- 2020/09/09
CRDT- 2020/09/23 06:36
PHST- 2020/09/23 06:36 [entrez]
PHST- 2020/09/24 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2020/09/09 00:00 [pmc-release]
AID - 10.5334/aogh.2719 [doi]
PST - epublish
SO  - Ann Glob Health. 2020 Sep 9;86(1):115. doi: 10.5334/aogh.2719.