The impact of the COVID-19 pandemic on secondary prevention of Rheumatic Heart Disease in Western Uganda

BackgroundRegular outpatient visits to healthcare facilities for benzathine penicillin injections are the primary means of secondary prevention for patients with Rheumatic Heart Disease (RHD). It has been widely demonstrated that individual access to healthcare has been disrupted by the COVID-19 outbreak, but its impact on RHD patients has not been studied. MethodsUsing a stratified random sampling strategy, we conducted a baseline and follow-up survey of RHD patients in Western Uganda between November 2019 and February 2020, and November 2020 and February 2021, and obtained 486 month-patient outpatient records. A fixed effect model and event-study analysis method were employed to investigate the impact of the COVID-19 pandemic on RHD patients secondary prevention. ResultsPrior to the outbreak of COVID-19, the average number of secondary prevention visits for RHD patients in Uganda were 9.48 per patient per year, which was far below the criteria of clinical guidelines. The secondary prevention visits decreased by an average of 0.12 visits per month in the COVID-19 pandemic, but the decrease was not statistically significant (P>0.05). The number of monthly secondary prevention visits among patients with RHD exhibited a gradual upward trend over time. The number of secondary prevention visits increased significantly (P<0.05) in the eight months following the COVID-19 outbreak in western Uganda. ConclusionsRHD patients in Western Uganda failed to adhere to the recommended frequency of secondary antibiotic prophylaxis prior to the outbreak of the COVID-19 pandemic, which decreased further during the pandemic. Improving the accessibility and convenience of treatment for RHD patients is a crucial step in enhancing the frequency of secondary prevention. Future pandemic preparations should consider the demands of secondary prevention among RHD patients.