Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
J Thromb Haemost. 2017 Sep;15(9):1770-1781. doi: 10.1111/jth.13769. Epub 2017 Aug 10.
Essentials Venous thromboembolism (VTE) is among the three main causes of cardiovascular disease worldwide. This review is the first to summarize the epidemiology of VTE in African populations. The prevalence of VTE in Africa is high following surgery, in pregnancy and post-partum. At least one quarter of patients at risk of VTE in Africa are not receiving prophylaxis.
Background Venous thromboembolism (VTE) is among the three leading causes of cardiovascular disease worldwide. Despite its high burden, there has been no previous study summarizing the epidemiology of VTE in African populations. Hence, we conducted this systematic review to determine the prevalence, incidence and mortality associated with VTE, and to evaluate the use of VTE prophylaxis in Africa. Methods We searched PubMed, Scopus and African Journals Online to identify articles published on VTE in Africa from inception to November 19, 2016, without language restriction. The reference list of eligible articles were further scrutinized to identify potential additional studies. Results Overall, we included 21 studies. The great majority of the studies yielded a moderate risk of bias. The prevalence of deep vein thrombosis (DVT) varied between 2.4% and 9.6% in postoperative patients, and between 380 and 448 per 100 000 births per year in pregnant and postpartum women. The prevalence of pulmonary embolism (PE) in medical patients varied between 0.14% and 61.5%, with a mortality rate of PE between 40% and 69.5%. The case-fatality rate after surgery was 60%. Overall, 31.7-75% of the patients were at risk of VTE, and between 34.2% and 96.5% of these received VTE prophylaxis. Conclusion The prevalence of VTE and associated mortality are high following surgery, and in pregnant and postpartum women in Africa. At least one-quarter of patients who are at risk for VTE in Africa are not receiving prophylaxis. These results are generated from studies with small sample size, highlighting an urgent need for well-designed studies with larger sample size to evaluate the true burden of VTE in Africa.
静脉血栓栓塞症（VTE）是全球心血管疾病的三大主要病因之一。本综述首次总结了非洲人群 VTE 的流行病学。非洲手术后、妊娠和产后 VTE 的患病率较高。非洲至少有四分之一的 VTE 高危患者未接受预防。
我们在 PubMed、Scopus 和 African Journals Online 上进行了检索，以确定从开始到 2016 年 11 月 19 日发表的有关非洲 VTE 的文章，不限制语言。还进一步审查了合格文章的参考文献列表，以确定潜在的其他研究。
总体而言，我们纳入了 21 项研究。大多数研究的偏倚风险较高。术后患者深静脉血栓形成（DVT）的患病率为 2.4%至 9.6%，妊娠和产后妇女每年每 100 000 例的 DVT 患病率为 380 至 448 例。内科患者肺栓塞（PE）的患病率为 0.14%至 61.5%，PE 的死亡率为 40%至 69.5%。手术后的病死率为 60%。总体而言，31.7%至 75%的患者存在 VTE 风险，其中 34.2%至 96.5%的患者接受了 VTE 预防。
非洲手术后以及妊娠和产后妇女 VTE 的患病率和相关死亡率较高。非洲至少有四分之一的 VTE 高危患者未接受预防。这些结果是由样本量较小的研究产生的，强调迫切需要设计良好的研究，以评估非洲 VTE 的真实负担。
