Practice of Prothrombin Time, Activated Partial Thromboplastin Time and Mixing Test in Public Hospitals of Addis Ababa, Ethiopia, from March - June 2016
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Date
2016-11
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Addis Ababa University
Abstract
Background: Coagulation tests are vital to the diagnosis, treatment as well as management of
bleeding and hypercoagulability disorders. Inappropriate performance of coagulation tests, such
as the prothrombin time (PT), activated partial thromboplastin time (aPTT) and mixing test
contributes to coagulation and bleeding complications including death. Practice of coagulation
tests is not well documented in resource limited settings like Ethiopia.
Objective: To assess the practice of PT, aPTT and Mixing test in public hospitals of Addis
Ababa from March - June 2016.
Methodology: A prospective hospital based cross-sectional study was conducted from March –
June 2016 in all the 13 public hospitals of Addis Ababa. Standard questionnaires and checklists
were used as a tool to investigate the practice of PT, aPTT and mixing test in the respective
hospitals. On site assessment was carried out using a checklist. Questionnaires were used to
interview all laboratory professionals working in hemostasis section during the data collection
period. Mixing tests were performed at Tikur Anbessa Specialized Hospital (TASH) on 40
plasma samples with prolonged PT/aPTT to demonstrate its usefulness and establish the
technique in this premier referral and teaching hospital of the country. Data was entered and
analyzed using SPSS version 21 employing descriptive statistics such as frequency and mean.
Result: Of all the 13 public hospitals in Addis Ababa, only 4 were performing either of the two
coagulation tests. The performance of PT/aPTT tests was irregular among the 4 hospitals and did
not comply with some SOPs. The results of this study indicate that the laboratories do not follow
certain testing guidelines. None of the hospitals perform mixing test. Out of the 40 patients for
whom mixing test was performed, 18 had a corrected mixing test results, suggesting factor
deficiency while 22 had no correction suggesting presence of inhibitors.
Conclusion: The practice of PT/aPTT tests in the public hospitals of Addis Ababa is insufficient.
Regardless of the vital role the mixing tests plays in the diagnosis, treatment and follow up of
patients with coagulopathy, it is not performed in any one of the public hospitals and none of the
laboratory professionals had the knowledge of it. This warrants efforts in establishing the test at
least at TASH.
Key words: Coagulation, PT, aPTT, Mixing Test, Hemostasis, public hospitals
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Keywords
Prothrombin Time, Thromboplastin Time, Public Hospitals