Abstract:
Cross-sectional study was conducted among rheumatic heart disease patients at Hiwot 
Fana Specialized Comprehensive University Hospital at cardiac clinic. The research was  
conducted among 240 rheumatic heart disease patients, who are on follow-up for at least 1 year 
at pediatric and medical cardiac clinic as well as those who were admitted to pediatric ward and 
medical ward, and study participants were sellected by purposive sampling technique. Data were 
entered to EPI data version 4.6 and analyzed using SPSS version 26 software. Descriptive 
statistics were done and the results were presented using texts, frequency tables and graphs. 
Bivariate and multivariate logistic regression with  95% CI were used to identify factors 
associated with level of adherence. Finally, statistical significance will be declared with a P value 
of less than 0.05. 
Results: A total of 240 rheumatic heart disease patients taking secondary prophylaxis were 
included in the analysis, and of those, 123 (51.8%) were male, and a male to female ratio of 
1.05:1. The mean age of participants was 13.59 years. The adherence rate of patients with 
rheumatic heart disease to secondary prophylaxis was 72.9%(95% CI 66.8-77.9%). Being a rural 
residence(AOR 2.813(95% CI 1.396-9.065),p=0.035), distance more than 20Km from 
hospital(AOR 4.493(95% CI 1.672-12.070), p=0.003), and lack of awareness of disease(AOR 
2.465(95% CI 1.103-5.507) p=0.028) were significantly associated with non adherence to 
secondary prophylaxis.   
Conclusion: A high magnitude of non-adharence to secondary prophylaxis was observed in 
patients with RHD at Hiwot Fana Sepecialized Comprehesive University Hospital. Patients with 
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RHD who live in rural area, came from distance of > 20Km, and lack of awareness of the disease 
were identified to be non-adherent to secondary prophylaxis.