Rheumatic Fever and Rheumatic Heart Disease related knowledge, attitudes, practices and health seeking experiences among people living in Fiji. — The Association Specialists
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  3. Rheumatic Fever and Rheumatic Heart Disease related knowledge, attitudes, practices and health seeking experiences among people living in Fiji.

Rheumatic Fever and Rheumatic Heart Disease related knowledge, attitudes, practices and health seeking experiences among people living in Fiji. (23920)

Jyoti Mani 1 , Roneel Chandra 1 , Jimaima Kailawadoko-Matanaicake 1 , Jokaveti Momo 1 , Shimron Prasad 1 , Eric Rafai 2 , Philip Hill 3 , Sue McAllister 3 , Bert van der Werf 4 , Andrew Steer 5 , Cameron Grant 4 , Bridget Kool 4 , Chris Bullen 4 , Donald Wilson 6 , Stephen Howie 4
  1. Cure Kids, Suva, Fij
  2. The Pacific Community, Suva, Fiji
  3. University of Otago, Dunedin, New Zealand
  4. University of Auckland, Auckland, New Zealand
  5. Murdoch Children’s Research Institute, Melbourne, Australia
  6. Fiji National Univesity, Suva, Fiji

Background

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are considered diseases of poverty. Community awareness plays an important role in primary prevention, especially in the absence of a Group-A Streptococcal vaccine. This study reports the knowledge, attitudes, and practices (KAP) related to ARF and RHD among people living in Fiji.

Methods

A cross-sectional KAP study was conducted from April to June 2023, recruiting adult participants from both structured (traditional Fijian villages) and unstructured (formal and informal settlements) settings in urban, rural, and maritime geographical zones in two regions of Fiji.

The multi-stage stratified sampling strategy accounted for variation at multiple levels: administrative divisions, medical areas, villages and settlements, and individuals. Trained field officers collected data on handheld devices using a structured questionnaire that described sociodemographic characteristics and KAP for sore throat, skin infection, ARF, and RHD.

Data describing KAPs were reported as proportions using R software. Thematic analysis was used for an open-ended question on health-seeking experiences.

Results

3905 adults participated from urban (42%), rural (35%), and maritime areas (23%). Two-thirds had not heard of ARF/RHD, while 40% did not know the signs or symptoms, and 50% did not know how a person acquires ARF/RHD. Less than half (40%) agreed they would seek medical care first for a sore throat or a skin infection.

Barriers to accessing healthcare included financial constraints, beliefs, and preferences for traditional medicine. Healthcare services were highlighted as suboptimal, with overcrowding, poor cleanliness, limited availability of medicine and equipment, and a shortage of health professionals.

Conclusion

Large gaps were found in community knowledge despite evidence suggesting reporting bias likely overestimated knowledge, and this highlights the need to raise awareness of ARF/RHD in Fiji to improve disease prevention and control. Financial barriers and a lack of confidence in services are key factors influencing care-seeking behaviours.