RESUMO
OBJECTIVES: To determine the level of adherence and possible barriers to secondary prophylaxis among clients with rheumatic fever in Kingston, Jamaica. METHODS: Cross-sectional survey of 39 clients diagnosed with rheumatic fever, receiving penicillin prophylaxis for more than a year using a 22-item self-administered questionnaire on adherence to secondary prophylaxis and knowledge of rheumatic fever. The patients' records were reviewed to determine the number of prophylaxis injections the patients received for the year 2010. RESULTS: The majority of participants (74%) were females and 51% were adults. Only 48·7% had a high level of adherence. The majority (72%) had low knowledge levels regarding their illness, while only 5% had a high knowledge level score. Most clients (70%) strongly agreed that nurses and doctors encouraged them to take their prophylaxis. However, over 60% reported that they travelled long distances and or waited long periods to get their injections. One-third reported that they missed appointments because of fear of injections and having to take time off from work or school. DISCUSSION: Clients attending the health centers studied had limited knowledge about rheumatic fever. Barriers to adherence included fear of the injections, long commutes, and long waiting periods at the facilities studied.
Assuntos
Antibacterianos/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Penicilinas/uso terapêutico , Febre Reumática/prevenção & controle , Prevenção Secundária/estatística & dados numéricos , Adolescente , Adulto , Antibioticoprofilaxia/psicologia , Antibioticoprofilaxia/estatística & dados numéricos , Criança , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Jamaica , Masculino , Adesão à Medicação/psicologia , Febre Reumática/psicologia , Adulto JovemRESUMO
AIM: The purpose of this study was to assess the oral health status of 104 children (2-17 years of age) at risk for infective endocarditis attending the Paediatric Cardiology Service of the Martagão Gesteira Institute of Child Care and Paediatrics, Rio de Janeiro, Brazil, and their guardians' attitudes towards and knowledge about endocarditis risks. METHODS: A structured interview was carried out with guardians and an oral examination was performed on each child to determine scores for the plaque index (PI), gingival index (GI) and dmft/DMFT index. RESULTS: The percentage of guardians who understood the meaning of 'heart infection' was 9.6%, who knew the possibility of heart disease caused by dental procedures was 60.6%, who understood the requirement for antibiotic cover before dental treatment was 72.1%, and who understood the importance of good oral health to prevent infective endocarditis was 41.3%. As regards oral health behaviours, 46.1% of children brushed their teeth three times or more a day, 28.8% had never visited a dentist before, and only 24.3% attended the dentist for prevention. There was visible plaque in 98% and gingival bleeding in 99% of children in this study. The caries experience for primary dentition (dmft) was 2.62%, and 3.97 for permanent dentition (DMFT). CONCLUSIONS: Based on these results, we can conclude that the guardians' knowledge and attitudes about oral health were not good. This group at risk has poor oral health, which may give rise to a frequent bacteraemia under physiological conditions.