Accelerating Delivery of rheumatic heart disease preventive iNterventions in Uganda (ADUNU)
乌干达加速实施风湿性心脏病预防干预措施 (ADUNU)
基本信息
- 批准号:10500950
- 负责人:
- 金额:$ 68.03万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-09-01 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:15 year oldAdherenceAdoptedAdoptionAntibiotic ProphylaxisAwarenessBenzathine PenicillinCardiacCardiovascular DiseasesCardiovascular systemCaringChargeChildClinicalCommunitiesCountryDataDecentralizationDetectionDiagnosisDimensionsEchocardiographyEffectivenessEndemic DiseasesEnrollmentEvaluationEvidence based practiceFailureFoundationsFundingGoalsGovernmentGuidelinesHIVHealthHealth PersonnelHealth Services AccessibilityHealth care facilityHealthcareHealthcare SystemsHeartHeart DiseasesHospital ReferralsHospitalsIndividualInjectionsInstitutesInterventionInterviewIntramuscularInvestmentsLightMaintenanceMapsMeasuresMethodsModelingNursesObservational StudyOutcomeOutcomes ResearchPatient-Focused OutcomesPatientsPenicillin GPersonsPopulationPrevalencePrimary Health CareProphylactic treatmentProtocols documentationProviderReach Effectiveness Adoption Implementation and MaintenanceRegistriesResearchResearch InfrastructureResolutionResource-limited settingResourcesRheumatic Heart DiseaseRunningSecondary PreventionService delivery modelSubgroupSystemTechnologyTestingTimeTrainingTravelUgandaWorkWorld Healthagedbasebudget impactcommunity centercommunity engaged researchcommunity settingcostcost effectivecost effectivenesscost estimatecost-effectiveness evaluationdesigndisease registrydisorder controlevidence baseexperienceexperimental studyhealth care deliveryimplementation determinantsimplementation strategyimprovedinnovationinsightlow and middle-income countrieslow income countrymarginalized populationmathematical modelmicrocostingneglectnovelpreventprevention servicepreventive interventionprogram costsprogramsprospectiveroutine practicescale upsuccesstooluptakeyoung adult
项目摘要
Project Summary Abstract
Rheumatic heart disease (RHD) is the most commonly acquired heart disease among children and young adults
worldwide. Continuous antibiotic prophylaxis (secondary prevention) with monthly intramuscular benzathine
penicillin G (BPG) is a cornerstone of RHD control programs and has been used successfully for decades in
wealthy countries. Unfortunately, because of neglect in the global and national health agendas, most RHD-
endemic countries (like Uganda) have no RHD programs, so most of the estimated 40 million people living with
RHD worldwide remain undiagnosed and unprotected from further valvular damage. Considering these
challenges, our objective is to partner with the Ugandan government to test a novel community-based program,
ADUNU (Acholi for “heart”) that aims to find individuals with RHD and provide secondary prevention close to
where they live. The program will be tested in two districts (one demonstration, one replication), building a
foundation for national scale-up beyond the proposed research. ADUNU is based on two core, evidence-based
technologies, (1) RHD testing using handheld echocardiography in community settings and (2) nurse-led,
registry-based delivery of secondary prevention. ADUNU is a non-randomized experiment that will set up a new
system in settings where RHD-related healthcare currently does not exist, with the goal of finding new cases and
enrolling them in local registries that provide secondary prevention. ADUNU will be integrated with general
primary healthcare and track outcomes over time, key factors in sustainability and scalability. In Aim 1, we will
evaluate ADUNU using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM)
framework, mapped to the RHD Care Cascade (an adaptation of the cascade used for HIV). Primary quantitative
outcomes in each of RE-AIM’s five dimensions will be supplemented with qualitative data from in-depth
interviews and administrative data. In Aim 2, we will evaluate the cost-effectiveness and budget impact of
ADUNU in these two districts in order to justify investment and plan for scale-up of the program nationally in
Uganda, beyond the proposed study. ADUNU will provide much-needed evidence to government
stakeholders in RHD-endemic countries, demonstrating how a pragmatic, community-based strategy
can deliver guideline-based care to people living with RHD. It will also provide critical, and currently
absent, evidence on the cost-effectiveness, affordability, and sustainability of RHD programs in
resource-limited settings.
项目摘要摘要
风湿性心脏病(RHD)是儿童和年轻人最常见的获得性心脏病
全世界。持续抗生素预防(二级预防),每月肌肉注射苯扎辛
青霉素G(BPG)是风湿性心脏病控制程序的基石,几十年来一直在风湿性心脏病的治疗中成功应用
富裕国家。不幸的是,由于全球和国家卫生议程中的忽视,大多数风湿性心脏病-
地方性疾病流行国家(如乌干达)没有风湿性心脏病项目,因此估计有4000万人患有风湿性心脏病
风湿性心脏病在世界范围内仍未得到诊断,也没有针对进一步的瓣膜损伤提供保护。考虑到这些
挑战,我们的目标是与乌干达政府合作,测试一项以社区为基础的新计划,
ADUNU(心脏的Acholi),旨在发现风湿性心脏病患者,并提供接近
他们住的地方。该计划将在两个地区进行测试(一个示范,一个推广),建立一个
除了拟议的研究之外,还为国家扩大规模提供了基础。ADUNU基于两个核心,以证据为基础
技术,(1)在社区环境中使用手持超声心动图进行RHD测试,(2)由护士领导,
以登记为基础提供二级预防。ADUNU是一项非随机实验,它将建立一个新的
目前不存在与风湿性心脏病相关的医疗保健的环境中的系统,目标是发现新病例和
将他们登记在提供二级预防的地方登记处。ADUNU将与General
初级医疗保健并跟踪随时间推移的结果,这是可持续性和可扩展性的关键因素。在目标1中,我们将
使用REACH、有效性、采用、实施和维护(RE-AIM)评估ADUNU
框架,映射到风湿性心脏病护理级联(用于艾滋病毒的级联的改编)。初级定量
在RE-AIM的五个维度中的每一个方面的结果都将得到来自深入的定性数据的补充
访谈和行政数据。在目标2中,我们将评估成本效益和预算影响
在这两个地区的ADUNU,以证明投资的合理性,并计划在#年在全国范围内扩大该计划
乌干达,除了拟议的研究之外。ADUNU将向政府提供急需的证据
风湿病流行国家的利益攸关方,展示了务实的、以社区为基础的战略
可以为风湿性心脏病患者提供基于指南的护理。它还将提供关键的、目前
缺乏关于RHD计划的成本效益、可负担性和可持续性的证据
资源受限设置。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Andrea Zawacki Beaton其他文献
Andrea Zawacki Beaton的其他文献
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{{ truncateString('Andrea Zawacki Beaton', 18)}}的其他基金
Intramuscular vs. Enteral Penicillin Prophylaxis to Prevent Progression of Latent Rheumatic Heart Disease: A non-inferiority randomized trial. (GOALIE)
肌肉注射与肠内青霉素预防预防潜在风湿性心脏病进展:一项非劣效性随机试验。
- 批准号:
10571212 - 财政年份:2023
- 资助金额:
$ 68.03万 - 项目类别:
Reducing the Impact of Rheumatic Heart Disease across the Life Span: The Impact Program
减少风湿性心脏病对整个生命周期的影响:影响计划
- 批准号:
10469186 - 财政年份:2022
- 资助金额:
$ 68.03万 - 项目类别:
Reducing the Impact of Rheumatic Heart Disease across the Life Span: The Impact Program
减少风湿性心脏病对整个生命周期的影响:影响计划
- 批准号:
10594560 - 财政年份:2022
- 资助金额:
$ 68.03万 - 项目类别:
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