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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
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Inge Smit,

Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, ZA
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Mark Emmanuel Engel,

Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, ZA
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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
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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
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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
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Published on 01 Sep 2019.
Peer Reviewed

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