ArticleBMJ public health2026
Establishing a National Deep Vein Thrombosis Network in Ghana: findings from a prospective observational study embedded in a capacity-building initiative.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), remains a significant cause of morbidity and mortality worldwide. However, epidemiological data and access to diagnostics and management of VTE remain limited in sub-Saharan Africa. This multicentre initiative aimed at strengthening capacity, enhancing management and establishing epidemiological data on VTE-focusing on DVT-in Ghana. Methods: The DVT network was established in nine hospitals across Ghana from 2018 to 2022. The initiative involved capacity building, technical infrastructure, including a train-the-trainers approach, mentorship, awareness workshops and campaigns. Epidemiological data were collected from patients with suspected DVT in two study phases. Results: Among 1422 patients with suspected DVT, diagnosis was confirmed by ultrasound in 44% (624/1422). Before the onset of symptoms suggestive of DVT, 25% of inpatients with active cancer (37/146) and 27% of inpatients with a history of DVT (8/30) were receiving anticoagulation. Following VTE confirmation, 96% (370/384) of patients who were assessed in the second phase of the project received anticoagulation. The all-cause in-hospital mortality rate evaluated in the second phase was found to be significantly higher among inpatients with confirmed VTE than in patients without (19%, 57/295 vs 4%, 15/415, p<0.001). Fifty-nine (19%) patients with DVT received a 3-month follow-up; 34% (20/59) experienced complete resolution; at 6 months, complete resolution increased to 71% (32/45). Conclusion: The high rate of confirmed DVT in suspected cases in Ghana highlights the need for targeted screening. Standardised capacity-building initiatives can be implemented across multiple hospitals, enhancing access to high-quality healthcare. While establishing specialised 'DVT centres' provides qualified management for referred patients, underdiagnosis of DVT and limited prophylaxis remain major challenges, underscoring the need to enhance nationwide thromboprophylaxis and healthcare access for patients with suspected DVT.
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