Date of Award

2024

Degree Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Advisor

ISAAC KIHURANI

Second Advisor

FREDRICK WERE

Department

Paediatrics and Child Health (East Africa)

Abstract

Introduction: Venous thromboembolism in children is a cause of significant morbidity and mortality worldwide with an increasing annual incidence. The present study aimed to increase awareness as well as attempt to inform the management of paediatric venous thromboembolism in this setting.

Objective: To describe the demographic and clinical characteristics of venous thromboembolism in children aged one month to 18 years at two tertiary hospitals in Kenya.

Methods: A descriptive retrospective chart review of patients aged one month to 18 years diagnosed with venous thromboembolism between January 2014 and December 2022 in two tertiary hospitals in Kenya was done. Data entry was done using Microsoft Excel and data analysis was conducted using Jamovi version 2.4.11. The study was approved by the mandated ethics committees. Continuous and discrete data were explored descriptively and summarized using median and interquartile ranges. Categorical data were summarized using frequencies and percentages. The results were presented using tables, bar charts and pie charts.

Results: Sixty patients were included in the present study with 5.6 venous thromboembolic events/ 10,000 hospital admissions documented. Venous thromboembolism was predominantly observed in adolescents at 41.7% with a female predominance of 61.7%. Most patients (86.7%) developed venous thromboembolism during their hospital stay. The median day to diagnosis was three days while the median length of hospital stay was 13 days. Underlying infection and malignancy were the most common comorbidities. Resolution of the thrombosis was documented in most patients (51.6%) and the case-fatality ratio was 11.7%.

Conclusion: The number of children with venous thromboembolism in this setting compares with that from high-income countries from two decades ago. At least a quarter of these patients had associated morbidity and mortality.

Recommendation: Early recognition and treatment of venous thromboembolism in children is essential to curb associated morbidity and mortality.

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