Pooled estimate of anticoagulation control with warfarin therapy among adult patients in Ethiopia: a systematic review and meta-analysis.

IF 2.7 4区医学 Q2 HEMATOLOGY

Thrombosis Journal Pub Date : 2026-05-18 DOI:10.1186/s12959-026-00865-6

Firafan Shuma Teka, Ayana Korsa, Bekan Gudata Gindaba, Gemechu Gelana Ararame, Jebesa Desisa Hordofa, Lalesa Tadesse Chuko, Nega Abebe Meshesha, Birbirsa Sefera Senbeta

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引用次数: 0

Abstract

BACKGROUND: Warfarin is widely used to prevent thromboembolic events; however, achieving optimal anticoagulation control remains challenging. In Africa, Time in Therapeutic Range (TTR) is generally low, and no nationally representative pooled estimate exists for Ethiopia. OBJECTIVE: To estimate adequate anticoagulation control (TTR ≥ 65%) among adult patients receiving warfarin therapy in Ethiopia. METHODS: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO (CRD420251271413). Databases including PubMed/MEDLINE, Scopus, Embase, Web of Science, African Journals Online, and Google Scholar were searched from inception to December 10, 2025. Observational studies conducted in Ethiopia among adult warfarin users reporting TTR were included, while studies lacking relevant outcomes or involving non-adult populations were excluded. Study quality was assessed using the Joanna Briggs Institute tool. A random-effects model was applied to estimate pooled anticoagulation control, and heterogeneity was evaluated using the I² statistic. RESULTS: Six studies comprising a total of 2,022 participants were included in this systematic review and meta-analysis. All studies were retrospective cross-sectional and conducted among adult patients receiving warfarin therapy in hospital settings across Ethiopia. The pooled estimate of adequate anticoagulation control (TTR ≥ 65%) was 34.30% (95% CI: 28.16–40.44), with substantial heterogeneity (I² = 79.09%). The mean TTR ranged from 29% to 47.24% across the included studies. Subgroup analysis showed relatively higher anticoagulation control in Addis Ababa (39.29%) compared to other regions (Amhara and Oromia) (22.19%). CONCLUSION: Anticoagulation control among Ethiopian patients on warfarin is suboptimal. Strengthening anticoagulation management services and establishing dedicated clinics are recommended.

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埃塞俄比亚成年患者使用华法林治疗抗凝控制的综合评估：系统回顾和荟萃分析。

背景：华法林被广泛用于预防血栓栓塞事件；然而，实现最佳抗凝控制仍然具有挑战性。在非洲，治疗范围内时间（TTR）普遍较低，埃塞俄比亚没有具有全国代表性的汇总估计。目的：评估埃塞俄比亚接受华法林治疗的成年患者的充分抗凝控制（TTR≥65%）。方法：按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价和荟萃分析，并在PROSPERO注册（CRD420251271413）。检索的数据库包括PubMed/MEDLINE、Scopus、Embase、Web of Science、African Journals Online和谷歌Scholar，检索时间从建站到2025年12月10日。在埃塞俄比亚对报告TTR的成年华法林使用者进行的观察性研究被纳入，而缺乏相关结果或涉及非成人人群的研究被排除。使用乔安娜布里格斯研究所的工具评估研究质量。随机效应模型用于估计合并抗凝控制，并使用I²统计量评估异质性。结果：本系统综述和荟萃分析纳入了6项研究，共纳入2,022名受试者。所有研究均为回顾性横断面研究，在埃塞俄比亚各地医院接受华法林治疗的成年患者中进行。充分抗凝控制（TTR≥65%）的合并估计为34.30% (95% CI: 28.16-40.44)，存在很大的异质性（I²= 79.09%）。在纳入的研究中，平均TTR范围为29%至47.24%。亚组分析显示，亚的斯亚贝巴的抗凝控制水平（39.29%）高于阿姆哈拉和奥罗米亚地区（22.19%）。结论：使用华法林的埃塞俄比亚患者抗凝控制不理想。建议加强抗凝管理服务并建立专门诊所。

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来源期刊

Thrombosis Journal Medicine-Hematology

CiteScore

3.80

自引率

3.20%

发文量

审稿时长

16 weeks

期刊介绍： Thrombosis Journal is an open-access journal that publishes original articles on aspects of clinical and basic research, new methodology, case reports and reviews in the areas of thrombosis. Topics of particular interest include the diagnosis of arterial and venous thrombosis, new antithrombotic treatments, new developments in the understanding, diagnosis and treatments of atherosclerotic vessel disease, relations between haemostasis and vascular disease, hypertension, diabetes, immunology and obesity.