Hubungan Pemberian Profilaksis Sekunder Benzathine Penisilin G terhadap Luaran pada Anak dengan Penyakit Jantung Reumatik di RSUP Haji Adam Malik Medan

Abstract

Background. Rheumatic heart disease is a chronic condition that is provoked by recurring Group A Streptococcus infection which induce an abnormal immune response that implicate in cumulative cardiac valve damage. GAS infection has higher prevalence in pediatric patients, particularly in crowded area with lower socioeconomic level and poor sanitation. In a condition where RHD therapy was not adequate, patient might be afflicted by cardiac valvular damages, heart failure, even death, simply by this highly preventable disease. Preventing recurrent attacks of RHD, by administering benzathine penicillin G secondary prophylaxis, is essential in suppressing the disease progression and complications. However, in clinical practice and several studies, it is frequently found that the use of secondary prophylaxis in children is still inadequate. Objectives. To determine whether there is an association of benzathine penicillin G secondary prophylaxis administration to the outcome of RHD in pediatric patient at Haji Adam Malik General Hospital Medan. Methods. An analytical observational study with a retrospective cohort design was conducted at Haji Adam Malik General Hospital Medan with total sampling technique on medical records in the period of April 2020 to July 2023. The data were then analyzed with Fisher Exact Test and Phi Coefficient to determine the significance and the strength of the association. Results. The Fisher Exact Test resulted in p < 0,001 and the strength of the association of the Phi Coefficient test was φ = 0,561. Conclusion. There is a strong and significant positive association between the administration of benzathine penicillin G secondary prophylaxis to the outcome of pediatric rheumatic heart disease in Haji Adam Malik General Hospital Medan.