GOALIE

Gwoko Adunu Pa Lutino: Intramuscular vs Enteral Penicillin Prophylaxis to Prevent Progression of Latent RHD

Although the GOAL Trial found that regular administration of injectable penicillin antibiotics can improve outcomes for children with the earliest forms of RHD (latent RHD), these monthly shots present challenges for patients (pain, missed school/work) and health systems (cost, training).

Could taking penicillin by mouth, rather than by monthly injections, provide the same amount of protection to children with early RHD? 

GOALIE is a randomized non-inferiority trial that will determine the effectiveness of injectable as compared to oral penicillin prophylaxis in preventing the progression of latent RHD at two years. GOALIE will also measure the costs, impact on quality of life, and patient and parent satisfaction of both approaches.

GOALIE will help determine whether oral penicillin can be used in the place of injectable penicillin prophylaxis for patients with latent RHD. This will inform international standards for the care of children with the earliest forms of RHD.

Patient and Parent Interviews: A cornerstone of the GOALIE project will be the qualitative data collected via surveys and interviews about patients’ quality of life.

+100

Participants will be enrolled

120,000

Children will be screened for RHD

1004

Parents will be interviewed

Project Site: Lira District

Project Dates: 2023-2028

Project Aims:

  1. Compare the proportion of children aged 5-17 years with latent RHD receiving oral penicillin who progress to worse valvular disease at two years compared to children who receive intramuscular (IM) penicillin.

  2. Evaluate the economic equivalence and cost-effectiveness of oral penicillin compared to IM penicillin, after echocardiographic screening for latent RHD detection.

  3. Compare patient-reported and parent-reported outcomes (treatment acceptance, treatment satisfaction, and health-related quality of life) between children receiving oral and IM penicillin prophylaxis.

Peer Groups

Case managers will support children in the GOALIE program by hosting regular peer groups where trial participants will gather to play games, receive health education, and benefit from peer support.

Community Engagement

GOALIE engages the community every step of the way, by hosting radio talks, partnering with the Community Advisory Board to learn how to best serve the local community, and providing general RHD education and awareness.