Pattern of venous thromboembolic diseases in a resources-limited setting in Cameroon

Abstract

Introduction: Admission for a medical illness is associated with an increased risk of venous thrombo-embolism; however reports addressing at this issue are rare in Cameroon. We sought to assess the pattern of thrombo-embolism among in-medical patients of a semi-urban hospital. Methods: We prospectively included 79 hospitalized medical patients of the Military Hospital of Bamenda (north-west region-Cameroon). From July 2010 and December 2013, we collected baseline demographic data, risk factors of venous thromboembolism, clinical presentation, diagnostic process and treatment. Results: In the 1445 patients admitted for medical illnesses, a total of 79 venous thrombo-embolic diseases were detected (55 deep vein thrombosis, 14 pulmonary embolism, 9 post-phlebitic syndrome and 1 cerulae alba dolens). The leading risk factors were prolonged immobilization (100%), age > 40 years (78.9%), obesity (43%), long distance travel (30.4%) and HIV-AIDS (21.5%). Thirty one (40.5%) had ≤ 2 cumulative risk factors, and 8 (10.1%) more than 4. All the patients in the group had a significant risk of deep vein thrombosis: 5 (6.3%), 34 (43%) and 40 (50.6%) with moderate, high and very high risk respectively. Increasing number of deep vein thrombosis was associated with increasing level of the risk and the clinical probability scores. Lower limb location of deep vein thrombosis was the most frequent with 75 (94.9%) cases. Almost all the patients received appropriate therapy with heparin and oral anticoagulant during their hospital stay. The mean length of hospital stay was 17.5 +/-15 (range 4- 62) days; disability and death occurred in 15 (19%) and 17 (21.5%) respectively. Conclusion: Venous thromboembolism is also a common concern in a semi-urban practice of our country. Long distance travel, one of the leading risk factors merits to be more specifically studied.

Pan African Medical Journal 2016; 23