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We aimed to investigate the adherence to <jats:styled-content style=\"fixed-case\">SAP<\/jats:styled-content> among young people with <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> diagnosed through echocardiographic screening in Fiji and to investigate factors associated with adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients diagnosed with <jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content> through echocardiographic screening in Fiji from 2006 to 2014 were included. Dates of benzathine penicillin G injections were collected from 76 health clinics nationally from December 2011 to December 2014. Adherence was measured using the proportion of days covered (<jats:styled-content style=\"fixed-case\">PDC<\/jats:styled-content>). Multivariate logistic regression analysis was used to identify characteristics associated with any adherence (\u22651 injection received) and adequate adherence (<jats:styled-content style=\"fixed-case\">PDC<\/jats:styled-content> \u22650.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 494 patients, 268 (54%) were female and the median age was 14 years. Overall, 203 (41%) had no injections recorded and just 33 (7%) had adequate adherence. Multivariate logistic regression showed increasing age (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.93 per year, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.87\u20130.99) and time since diagnosis \u22651.5 years (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.53, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.37\u20130.79) to be inversely associated with any adherence. Non\u2010<jats:styled-content style=\"fixed-case\">iT<\/jats:styled-content>aukei ethnicity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.58, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.04\u20136.33) and urban residence (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.36, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.54\u20137.36) were associated with adequate adherence, whereas time since diagnosis \u22651.5 years (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.38, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.17\u20130.83) was inversely associated with adequate adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adherence to <jats:styled-content style=\"fixed-case\">SAP<\/jats:styled-content> after screening in Fiji is currently inadequate for individual patient protection or population disease control. Secondary prevention should be strengthened before further screening can be justified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12796","type":"journal-article","created":{"date-parts":[[2016,10,13]],"date-time":"2016-10-13T18:22:44Z","timestamp":1476382964000},"page":"1583-1591","source":"Crossref","is-referenced-by-count":22,"title":["Adherence to secondary antibiotic prophylaxis for patients with rheumatic heart disease diagnosed through screening in Fiji"],"prefix":"10.1111","volume":"21","author":[{"given":"Daniel","family":"Engelman","sequence":"first","affiliation":[{"name":"Department of Paediatrics University of Melbourne Parkville Vic Australia"},{"name":"Murdoch Childrens Research Institute Parkville Vic Australia"},{"name":"Royal Children's Hospital Parkville Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reapi L.","family":"Mataika","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Colonial War Memorial Hospital Suva Fiji"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph H.","family":"Kado","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Colonial War Memorial Hospital Suva Fiji"},{"name":"College of Medicine, Nursing and Health Sciences Fiji National University Suva Fiji"},{"name":"Fiji Rheumatic Heart Disease Control Program Suva Fiji"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"Ah Kee","sequence":"additional","affiliation":[{"name":"Fiji Rheumatic Heart Disease Control Program Suva Fiji"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Donath","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Parkville Vic Australia"},{"name":"Murdoch Childrens Research Institute Parkville Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Parks","sequence":"additional","affiliation":[{"name":"Wellcome Trust Centre for Human Genetics University of Oxford Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew C.","family":"Steer","sequence":"additional","affiliation":[{"name":"Department of Paediatrics University of Melbourne Parkville Vic Australia"},{"name":"Murdoch Childrens Research Institute Parkville Vic Australia"},{"name":"Royal Children's Hospital Parkville Vic Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,28]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gheart.2013.08.008"},{"key":"e_1_2_6_4_1","volume-title":"Dept. of Child and Adolescent Health and Development. 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