Magnitudes of Risk Factors of Venous Thromboembolism and Quality of Anticoagulant Therapy in Ethiopia: A Systematic Review

Abstract

Background

Venous thromboembolism is one of the major public health problems in the world. Though several studies were conducted to estimate common risk factors of venous thromboembolism and quality of anticoagulant therapy in Ethiopia, it is difficult to estimate the overall burdens of risk factors and quality of anticoagulant use because of the lack of a nationwide study.

Objective

To assess magnitudes of risk factors of venous thromboembolism and quality of anticoagulant therapy in Ethiopia.

Materials and Methods

Electronic searching using PubMed, EMBASE, Science Direct, Cochrane Database, Scopus, Hinari, Sci-Hub, African Journals Online Library, and Free-text Web Searches using Google Scholar was conducted from September, 15 to October 27, 2021. Each of the original studies was identified by Mesh terms and Boolean search technique using full title, various keywords and was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. The data were extracted using a format prepared in Microsoft Excel and exported to STATA 14.0 for the outcome analyses.

Results

The database search delivered a total of 2118 studies. After articles were removed by duplications, titles, reading the abstract, and assessed for eligibility criteria, 12 articles were found suitable for the systematic review. Prolonged immobilization (41.30%) was the most commonly observed risk factor of venous thrombosis followed by acute infection (40.25%). The proportion of therapeutic range (INR = 2–3), sub-therapeutic range (INR <2), and supra-therapeutic range (INR >3) were 32.15%, 47.58%, and 17.62%, respectively. One hundred and thirty-eight patients (11.4%) have developed minor or major bleeding complications.

Conclusion

Prolonged immobilization and acute infection were the main risk factors for venous thromboembolism. The quality of anticoagulant therapy in Ethiopia was poor and bleeding complications were high. A strong effort is needed to improve the quality of anticoagulation and close monitoring of patients’ international normalized ratio is required to improve treatment outcomes.

Keywords:

• anticoagulant
• risk assessment
• thrombosis
• risk factors
• venous thromboembolism
• Ethiopia

Abbreviations

DMCSH, Debre Markos Comprehensive Specialized Hospital; DVT, deep Vein thrombosis; ICU, intensive care unit; INR, international normalized ratio; LMWH, low molecular weight heparin; NCD, non-communicable diseases; PE, pulmonary embolism; UFH, unfractionated heparin; VTE, venous thromboembolism.

Data Sharing Statement

All relevant data are within the manuscript and its Supplementary material.

Author Contributions

Both authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

The authors received no specific funding for this work.