School of Public Health, Southeast University, Nanjing, China.
School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.
Eur J Med Res. 2024 Jun 16;29(1):333. doi: 10.1186/s40001-024-01934-0.
Adverse drug events (ADEs) represent challenges affecting Africa's healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs.
We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa.
Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095).
We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2-21.4%) and 74.2% (IQR: 54.1-90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5-9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6-56.1%) and 32.6% (IQR: 26.0-41.3%), respectively, with a median of 43.5% (IQR: 16.3-59.0%) and 12.4% (IQR: 7.1-28.1%) of ADEs being preventable in general and specific patients, respectively.
The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.
药物不良反应（ADE）给非洲的医疗体系带来了挑战，因为 ADE 增加了医疗支出并导致了不良的健康后果。
我们旨在系统地回顾已发表的关于 ADE 的研究，并综合现有证据来评估非洲 ADE 的流行率。
通过检索 PubMed、EBSCO、Science Direct 和 Web of Science，确定了 2000 年 1 月 1 日至 2023 年 10 月 1 日期间发表的关于非洲 ADE 发生情况的研究。明确研究了由临床情况（如 HIV 患者）引起的 ADE 或由特定药物暴露（如抗生素）引起的 ADE 的研究被认为是具体的，其余的则为一般的。使用中位数和四分位距（IQR）描述分组的 ADE 流行率。PROSPERO 注册（CRD42022374095）。
我们纳入了来自 15 个非洲国家的 78 项观察性研究，这些研究调查了导致住院的 ADE 发生率（17 项研究）、住院期间发生的 ADE 发生率（30 项研究）、在门诊部门（38 项研究）或社区（4 项研究）中发生的 ADE 发生率。12 项研究包括多个环境。一般和特定患者住院期间 ADE 的中位发生率分别为 7.8%（IQR：4.2-21.4%）和 74.2%（IQR：54.1-90.7%）。一般和特定患者中与 ADE 相关的死亡率分别为 0.1%和 1.3%。一般情况下，导致住院的 ADE 总中位发生率为 6.0%（IQR：1.5-9.0%）；在一般情况下，门诊和社区环境中 ADE 的中位发生率分别为 22.9%（IQR：14.6-56.1%）和 32.6%（IQR：26.0-41.3%），一般和特定患者中可预防的 ADE 分别为 43.5%（IQR：16.3-59.0%）和 12.4%（IQR：7.1-28.1%）。
非洲的医院和社区环境中 ADE 的流行率都很高。特定患者中观察到 ADE 发生率较高，这强调了需要在各个环境中，特别是在高危患者群体（如儿科、HIV 和结核病患者）中进行改进的重要领域。由于在社区环境中进行的研究有限，鼓励在该环境中开展未来的研究。
