Pulmonary thromboembolism in an East African tertiary referral hospital

Abstract

Pulmonary thromboembolism (PTE) is a frequent cause of mortality in Kenya, but its characteristics are hardly reported in Subsaharan Africa. To describe the pattern of PTE among black Africans, in a Kenyan referral hospital. Retrospective study at Kenyatta National Hospital (KNH), Nairobi, Kenya. Records of patients seen between January 2005 and December 2009 were examined for mode of diagnosis, comorbidities, age, gender, treatment and outcome. Data were analyzed using SPSS version 15.0 and are presented in tables and bar charts. One hundred and twenty-eight (60 male; 68 female) cases were analyzed. Diagnosis was made by clinical evaluation, a Well's score of >4.0, high D-dimer levels and ultrasound demonstration of a proximal deep venous thrombosis (DVT, 35.9%), lung spiral computer tomography (CT, 50%), multidetector CT (7.8%) and angiography (6.3%). Most frequent comorbidities included DVT (36%); hypertension (18.8%); pulmonary tuberculosis (PTB, 12.5%); HIV infection (10.9%), pueperium, diabetes mellitus and cigarette smoking (9.4% each). Mean age was 40.8 years (range 5-86 years) with a peak between 30 and 50 years. Over 46% of patients were aged 40 years and less. Male:female ratio was 1:1.13. All the patients were treated with anticoagulants and thrombolytics with only one having embolectomy. Ninety-two patients (71.9%) recovered, 18.8% of them with cor pulmonale, while 28.1% died. PTE is not uncommon in Kenya. It affects many individuals below 40 years without a gender bias, and carries high morbidity and mortality. Associated comorbidities include venous thrombosis, lifestyle conditions and communicable diseases. Control measures targeting both are recommended.

Epidemiology, Clinical Presentations and In-Hospital Mortality of Venous Thromboembolism at the Douala General Hospital: A Cross-Sectional Study in Cameroon, Sub-Saharan Africa

“…The male predominance this study is similar to the 55% reported by Kingue et al in Yaoundé-Cameroon [17], and different from that reported by that reported by Ogeng'o et al at an East African tertiary referral hospital [6]. The mean age of or patients was lower than the 60 ± 11.7 years reported by Aissa et al [7] in Tunisia, but higher that reported by Kingue et al [17] and Ogengo'o et al [6], who reported a mean age of 46 and 40.8 years respectively.…”

“…The mean age of or patients was lower than the 60 ± 11.7 years reported by Aissa et al [7] in Tunisia, but higher that reported by Kingue et al [17] and Ogengo'o et al [6], who reported a mean age of 46 and 40.8 years respectively. [3].…”

“…Autopsy reports showed a prevalence of 2.9% to 3.8% [3] [4], with an in-hospital incidence of 0.1% in Nigeria [5]. Data on the epidemiology of VTE are scarce in sub-Saharan Africa (SSA), with an in-hospital prevalence of 7% [6] [7] [8]. The yield for acute pulmonary embolism (PE) was 37.5% for suspected cases [9].…”

Pulmonary thromboembolism in an emergency hospital: Are our patients different?

“…PTE diagnosis represented 0.31% of all hospitalizations during the 2-year studied period, an incidence rate similar to those reported in the United States (between 0.047-0.40%) [7]. Our data is limited to PE patients who were hospitalized, and PTE diagnosis could be more frequent in the emergency department, even though admittance rates reported in the US are around 86% [8].…”

Venous thromboembolic disease in Burkina Faso: results of the prospective registry REMAVET (registry of Venous Thromboembolic)

“…Pulmonary Emboli occur in 23 to 107 per 100,000 residents in France [4]. There are limited epidemiologic data in Africa, and the majority of authors estimate the hospital incidence to be 1.2% to 3.1% [5,6,7,8]. In 2014, thromboembolic diseases were the second cause of hospital admissions for cardiovascular diseases, after heart failure in the cardiology service in Burkina Faso.…”