GOAL-Post

A Long-Term Follow-up Study for Patients who Participated in the GOAL Trial

The GOAL Trial determined that monthly penicillin injections can improve 2-year outcomes for children with early RHD. However, there are still remaining questions about how long children should remain on prophylaxis.

How long should children with latent RHD receive BPG injections? Can children who have resolution of heart disease by echocardiogram safely come off of prophylaxis?

GOAL-Post is designed to learn more about how long children diagnosed with early RHD should continue to receive antibiotic protection. GOAL-Post will help refine treatment recommendations for children with the earliest forms of RHD.

GOAL-Post will provide important guidance for the duration of treatment once a child is found to have early RHD. This information is important for children and families and for healthcare systems who are providing care.

Peer Groups: Participants in GOAL-Post receive support through peer play groups, which provide emotional support, contact with project staff, and health education to support children to remain in the study and in care.

750+

Patients retained from the GOAL study

4500+

Months of prophylaxis coverage

694

New echo screenings performed

Project Site: Gulu District

Project Dates: 2021-2024

Project Aims:

  1. Compare the two-year risk of developing RHD between children who completed the GOAL Trial with a normal echocardiogram (prior diagnosis of latent RHD) and matched controls with repeated normal echocardiograms.

  2. Determine the five-year rate of RHD progression and regression among children with persistent latent RHD who receive secondary antibiotic prophylaxis. 

A Specialized Injection Protocol

As with the GOAL Trial, the GOAL-Post BPG injection protocol includes offering children distractors and a vibrating tool to assist with pain relief. 

Community Education

As part of the project and RRCU community engagement program, the GOAL-Post staff educates the broader community about sore throat, acute rheumatic fever and RHD.

Engaged Care

A tenet of the trial’s community-informed design includes routine text and call follow-up from a team of project case managers and nurses who can help mitigate barriers to medication adherence.