CARDIOVASCULAR JOURNAL OF AFRICA • Volume 25, No 4, July/August 2014
AFRICA
159
Epidemiological African day for evaluation of patients at
risk of venous thrombosis in acute hospital care settings
Samuel Kingue, Limbole Bakilo, Jacqueline Ze Minkande, Inoussa Fifen, Yash Pal Gureja,
Henri Jean Claude Razafimahandry, Njideka Okubadejo, Richard Mvuala, DA Oke, Alexandre Manga,
Tovohery Rajaonera, Cajetan Nwadinigwe, Emmanuel Pay Pay, Nirina Rabearivony
Abstract
Introduction:
This study aimed to identify patients at risk for
venous thromboembolism (VTE) among all patients hospi-
talised, and to determine the proportion of at-risk hospital
patients who received effective types of VTE prophylaxis in
sub-Saharan Africa (SSA).
Methods:
A multinational, observational, cross-sectional
survey was carried out on 1 583 at-risk patients throughout
five SSA countries.
Results:
The prevalence of VTE risk was 50.4% overall, 62.3%
in medical and 43.8% in surgical patients. The proportion
of at-risk patients receiving prophylaxis was 51.5% overall,
36.2% in medical and 64% in surgical patients. Low-molecular
weight heparin was the most frequently used prophylactic
method in 40.2% overall, 23.1% in medical and 49.9% in
surgical patients.
Discussion:
This study showed a high prevalence of VTE
risk among hospitalised patients and that less than half of
all at-risk patients received an American College of Clinical
Pharmacy-recommended method of prophylaxis.
Conclusion:
Recommended VTE prophylaxis is underused in
SSA.
Keywords:
thromboprophylaxis, venous thromboembolism,
ENDORSE-Africa
Submitted 18/1/13, accepted 9/5/14
Cardiovasc J Afr
2014;
25
: 159–164
DOI: 10.5830/CVJA-2014-025
Acute venous thromboembolism (VTE) is a complication in
patients hospitalised for a wide variety of acute medical and
surgical conditions.
1,2
In developed countries, VTE is the most
common preventable cause of death among hospitalised patients.
Over the last 30 years, extensive research has demonstrated a
high risk of VTE in patients who undergo major surgery or
experience severe trauma. Patients hospitalised for acute medical
illness have approximately the same level of VTE risk as patients
who undergo major general surgery.
3-5
The benefits of VTE prophylaxis are similar for both medical
and moderate-risk surgical patients.
6,7
VTE prophylaxis is
substantially underused. There is great variation in the use of
prophylaxis between countries. Even when prophylaxis is used,
it may be used sub-optimally.
8-10
Although some surveys and
studies suggest that physicians have begun to recognise VTE as
a serious health problem and use prophylaxis for at least some
high-risk patients, a number of recent studies demonstrate that
VTE prophylaxis remains underutilised.
11-20
Department of Cardiology, General Hospital, Yaoundé,
Cameroon
Samuel Kingue, MD
Department of Internal Medicine, Clinic Ngaliema,
Kinshasa, DRC
Limbole Bakilo, MD
Richard Mvuala, MD
Department of Anaesthesiology and Reanimation,
Hospital Gynéco obstetrique et Pédiatrique, Yaoundé,
Cameroon
Jacqueline Ze Minkande, MD
SANOFI, North-East Africa, Lagos, Nigeria
Inoussa Fifen, MD,
Orthopaedic Department, Princess Marina Hospital,
Gaborone, Botswana
Yash Pal Gureja, MD
Orthopaedist, Antananarivo, Madagascar
Henri Jean Claude Razafimahandry, MD
Department of Neurology, Lagos University Teaching
Hospital, Lagos, Nigeria
Njideka Okubadejo, MD
Department of Cardiology, Lagos University Teaching
Hospital, Lagos, Nigeria
DA Oke, MD
Orthopaedic Department, Hopital du Caisse nationale de
prévoyance Sociale, Yaoundé Cameroon
Alexandre Manga, MD
Department of Anaesthesiology and Reanimation, Mother
and Child Hospital, Antananarivo, Madagascar
Tovohery Rajaonera, MD
National Orthopaedic Hospital, Enugu, Nigeria
Nwadinigwe Cajetan, MD
Orthopaedic Department, Clinic Ngaliema, Kinshasa, DRC
Emmanuel Pay Pay, MD
Department of Cardiology, Mother and Child Hospital,
Antananarivo, Madagascar
Nirina Rabearivony, MD
