Original Research
Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease: A Systematic Review
Authors:
Leila Hussein Abdullahi,
Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, ZA; Save the Children International, Somalia/Somaliland Country Office, Nairobi, KE
Inge Smit,
Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, ZA
Mark Emmanuel Engel,
Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
David Alan Watkins,
Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, ZA; Division of General Internal Medicine, University of Washington, Seattle, WA, US
Liesl Joanna Zühlke
Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, ZA; Save the Children International, Somalia/Somaliland Country Office, Nairobi, KE
Abstract
Background: Globally, rheumatic heart disease (RHD) is a major contributor to the burden of cardiovascular disease. Major gaps in RHD prevention and treatment have been documented at all levels of health systems in low- and middle-income countries. Task sharing is an approach that could prove effective in remediating bottlenecks in RHD-related care.
Objectives: This study conducted a systematic review to assess the state of the evidence for the use of task sharing in the diagnosis, prevention, and management of RHD.
Methods: Guided by a previously published protocol, we searched various databases using a systematic search strategy including MeSH and free-text terms for (1) group A streptococcus, acute rheumatic fever, and RHD and (2) strategies of task sharing in limited-resource settings. Two investigators independently screened the search outputs, selected the studies, extracted the data, and assessed the risk of bias, resolving discrepancies by discussion and consensus.
Results: The publications search yielded 212 records, of which 18 articles were deemed as potentially eligible for inclusion. None of the studies, however, met with the inclusion criteria.
Conclusions: There is a lack of evidence for the use of task-sharing approaches in scaling up RHD prevention and treatment services in limited-resource settings. Considering the persistent burden of group A streptococcus, acute rheumatic fever, and RHD in low- and middle-income countries, this work highlights the urgent need to develop and test models of RHD-related care utilizing an evidence-based approach to task sharing. [Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease: A Systematic Review; CRD42017072989].
Highlights
- RHD is an important cause of cardiovascular disease.
- Major gaps in RHD prevention and treatment exist in developing countries.
- Task sharing could prove effective in remediating bottlenecks in RHD-related care.
- Our systematic review found no evidence that task sharing can improve RHD outcomes.
- We need to develop and test evidence-based models of RHD care using task sharing.
How to Cite:
Abdullahi LH, Smit I, Engel ME, Watkins DA, Zühlke LJ. Task Sharing in the Diagnosis, Prevention, and Management of Rheumatic Heart Disease: A Systematic Review. Global Heart. 2019;14(3):259–64. DOI: http://doi.org/10.1016/j.gheart.2019.04.002
Published on
01 Sep 2019.
Peer Reviewed
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