Knowledge of healthcare workers in early recognition, diagnosis and management of Rheumatic Fever and Rheumatic Heart Disease in primary healthcare settings of Far-western Nepal: Measuring the impact of educational interventions.

Research Report.

ABSTRACT: Introduction: Rheumatic Fever and Rheumatic Heart Disease continue to remain a major public health problem and the leading cause of heart disease in Nepal. Although preventable and treatable, lack of proper knowledge and resources to diagnose and manage them in rural health centers is one of the major issues. This study aimed to assess the knowledge of healthcare workers in early recognition, diagnosis and management of Rheumatic Fever and Rheumatic Heart Disease in rural healthcare settings. Methods: It was a prospective, cross-sectional and health facility-based study. A total of 64 healthcare workers working in Achham district of Far-west Nepal were included in teaching sessions in one hospital and two primary health care centers. A self-administered questionnaire was used in pre- and post-teaching sessions to assess the knowledge of healthcare workers in early recognition, diagnosis and management of rheumatic fever and rheumatic heart disease. Results: The mean knowledge score among healthcare workers increased from 9.9 (SD =2.4) pre-lecture to 13.6 (SD =1.9) after the teaching session (P-value <0.05). The mean score of confidence among healthcare workers on differentiating bacterial from viral sore throat clinically raised from 3.6 (SD =1.08) pre-lecture to 3.98 (SD =1.09) post-lecture (P-value <0.05) while the mean score of their confidence in managing rheumatic fever improved from 3.9 (SD =0.88) pre-lecture to 4.30 (SD =0.84) post-lecture (P-value <0.001). Conclusion: The overall knowledge of healthcare providers was found to improve after the educational intervention. Hence, it is recommended to frequently conduct informative and resourceful sessions for healthcare providers, mainly in the health facilities in rural settings so that timely interventions could be delineated for the prevention and management of rheumatic fever and rheumatic heart disease in Nepal.