Accelerating Delivery of Rheumatic Heart Disease Prevention and Care Services in Northern Uganda A District-Based Program Using Echocardiography and Registry Follow-up

What this Trial Is About

This research aims to evaluate the feasibility, sustainability, and public health impact of a district-based program for secondary prevention of Rheumatic Heart Disease RHD in Uganda. It is a non-randomized study testing the implementation of decentralized RHD preventive services, overseen by the Uganda Ministry of Health and District Health Offices in partnership with a technical quality assurance team. The study uses the RE-AIM framework to measure program reach, effectiveness, adoption, implementation, and maintenance while also estimating cost-effectiveness and budget impact. The study involves the ADUNU program, which integrates echocardiographic screening for RHD in children and young adults through community and facility-based testing. The program also includes registry-based secondary prophylaxis injections of Benzathine penicillin G BPG administered at local health centers HCIII and HCIV in the participating districts. This approach is designed to improve access to care and maintain patients linked to treatment. Participants and healthcare providers residing or working in the involved districts will engage with the program over several years. Researchers will assess the proportion of persons reached, enrolled, retained, and adherent to treatment at multiple time points up to five years. They will also evaluate program adoption and implementation at organizational, provider, and patient levels through surveys and interviews, alongside a cost analysis of the program at three years. The study ensures ongoing monitoring of adherence and outcomes to understand the programs public health impact.

Accelerating Delivery of rheUmatic Heart Disease Preventive iNterventions in Northern Uganda