Thrombosis has been identified as one of the leading causes of death, especially blood clot-related deaths, and pregnancy increases the rate of this condition.
Currently in Nigeria, no data exist on its prevalence but, in an attempt to increase awareness of thrombosis, Nigeria’s Spokesperson for World Thrombosis Day (WTD), Dr. Helen C. Okoye, discusses the disorder, otherwise known as blood clot in the vein, with THERESA MOSES.
Can you tell us about your role as Nigeria’s spokesperson for World Thrombosis Day and what inspired you to take on this position?
My role as Nigeria’s spokesperson for World Thrombosis Day includes but not limited to developing, directing, and overseeing the WTD campaign goals and objectives. These goals and objectives are summarised as follows: highlighting the burden of thrombosis, increasing awareness of thrombosis, empowering individuals on issues of thrombosis, and playing the advocacy role of preventing, diagnosing, and treating thrombosis. My role also includes implementing and providing hands-on scientific and medical guidance and expertise for all campaign-related contents in the country.
I draw my inspiration from our little beginnings. We started this WTD campaign in our local hospital and saw how the diagnosis of thrombotic disorders increased. People became aware of it and looked out for it, which also led to the establishment of preventive measures against thrombosis.
Thrombosis is a serious medical condition. Could you explain in simple terms what it is and why it’s important for people to be aware of it?
In simple terms, thrombosis is the inappropriate clotting of blood within the vessel such that it prevents the free flow of nutrients and oxygen. It should be taken seriously because thrombosis contributes directly or indirectly to the commonest causes of death globally, including in Nigeria. It is preventable and, as such, many deaths can be avoided.
How prevalent is thrombosis in Nigeria and what are some common misconceptions that people might have about the condition?
Even though we do not have nationwide data on the prevalence of thrombosis, it is not uncommon in Nigeria. Emanating pockets of evidence from different places and populations within the country suggest a significant burden of thrombosis in Nigeria. The reported prevalence ranges from 2.4 per cent to 9.6 per cent, and is even higher post-operatively. One of the common misconceptions people have about thrombosis in Nigeria is that most people think thrombosis is a problem for whites or the elderly. Other misconceptions include thinking thrombosis is more prevalent in women and the very sick. People believe that once they are physically active, they cannot develop thrombosis. And, of course, any strange or unexplained condition is often regarded by neighbours as ‘spiritual’ or ‘from village people.’
What are the risk factors for developing thrombosis, and are there any specific strands that are more common in the Nigerian population?
The risk factors for thrombosis can broadly be divided into two categories: the inherited factors or thrombophilias, and the acquired risk factors, or acquired thrombophilias. The inherited factors include deficiency of some of the natural anticoagulants due to some mutations, for example, protein C deficiency, protein S deficiency, and antithrombin deficiency. Some of the acquired risk factors are chest infections, cancers, surgeries, traumas, obesity, long hospital stays, pregnancy, and so on. Smoking, hypertension, diabetes mellitus, a sedentary lifestyle, a poor diet, and long-haul travel are notable causes as well. In Nigeria, acquired risk factors are more prevalent.
How can individuals reduce the risk of thrombosis; and what are some practical steps people can take in their daily lives?
Knowing the risk factors for thrombosis is the first step to reducing the risk. Even though some of the risk factors are non-modifiable, most of the acquired ones can be modified. Moving around every 2-3 hours can help let blood circulate within the vessels, thereby reducing the risk of clot formation. Good diet and weight control, lots of water, stopping smoking, and controlling your blood sugar and cholesterol. When you go to the hospital, ask your doctor to risk-access you. There may be a need to thrombo-prophylax you. For those at risk of a sedentary lifestyle, you can take up the WTD 60 for 60 Challenge to move against thrombosis, which encourages you to get up and move every 60 minutes for 60 seconds.
World Thrombosis Day aims to raise awareness about the condition. Could you share some initiatives or activities that you’ve been involved in to spread awareness in Nigeria?
We have done a number of activities as part of our campaign, like taking awareness marches on the university campus, in the hospital community, and in malls; we have done some radio shows; and we have done seminars as well as webinars. Just recently, during the annual conference of our society, the Nigerian Society for Haematology and Blood Transfusion, we organised a ‘Move Against Thrombosis’ event where we walked around the city of Abuja, talking about thrombosis. I have also granted interviews to media houses talking about the prevention, diagnosis, and treatment of thrombosis. We have also written articles that are accessible to the public.
Are there any specific signs or symptoms that people should watch out for, and when should someone seek medical attention if they suspect they might have thrombosis?
The signs and symptoms depend on the location of the clot. For deep vein thrombosis, the signs and symptoms experienced may include pain, swelling, and a change in the colour of the site. For pulmonary embolism, the individual may develop a sudden cough and breathlessness, haemoptysis, chest pain, a rapid pulse, and feelings of anxiety and lightheadedness. These features are nonspecific, so once you have the risk factors and start experiencing any of those symptoms, see your doctor immediately. If you have any reason to be in the hospital, ask your doctor to risk-access you.
What advancements have been made in terms of diagnosing and treating thrombosis, and how has this impacted patient outcomes?
Over the past months, the diagnosis of thrombosis has improved. With the introduction of the hospital safety system, the implementation of risk assessment for all patients on admission, and the availability of radiological tests, more patients are identified and diagnosed. Early diagnosis of deep vein thrombosis helps prevent pulmonary embolisms and other complications, including death.
Education plays a crucial role in preventing and managing thrombosis. How are you working to educate both the general public and medical professionals about this condition?
In education, we are trying a number of things. We organise regular seminars and webinars for health care professionals. We have a hospital VTE audit committee, which has helped in further training and retraining healthcare professionals. For the general public, we started by evaluating their level of knowledge and awareness through a survey which results have been published in a peer-reviewed journal. The results from the survey have helped us design appropriate education for them. This we have done through media houses, public awareness talks, and seminars.
What advice would you give to individuals who may have a family history of thrombosis or are at higher risk due to other health conditions?
My advice would be to see a haematologist who would review them for possible thrombo-prophylaxis, as the case may be.
In your opinion, what more can be done at a global and local level to increase awareness about thrombosis and improve its prevention and management?
In my opinion, more focus should be placed on those individuals in the rural community who probably do not have access to social media and find ways of getting the message to them. Again, the curriculum for medical students can be adjusted to include the proper teaching of thrombosis and thrombotic disorders. Establishing a VTE audit committee in our various hospitals may help in the prevention of clots. Regular training and retraining of healthcare professionals are of utmost importance.
- Dr. Okoye is a lecturer and a Consultant Haematologist at the University of Nigeria, Enugu Campus, Enugu State, Nigeria.
- She received her basic medical qualification (MBBS) in Nigeria and obtained an MSc in Human Reproduction and Women’s Health. Recently, she earned an MD degree in pathology. She is a Fellow of both the West African College of Physicians (FWACP LabMed) and the National Postgraduate Medical College of Nigeria (FMCPath).
- Helen is currently a member of the World Thrombosis Day Steering Committee and Women’s Health Scientific Sub-committee and a past recipient of the Reach-the-World Fellowship of the International Society on Thrombosis and Haemostasis (ISTH).
- Dr Okoye’s areas of research include thrombosis, haemostasis and women’s health. She has carried out several researches in haematology and obstetrics, and has authored over 60 peer-reviewed academic articles that have been published in reputable journals.
- In addition to being a member of several international and national professional societies, she has distinguished herself as a member of the Thrombosis and Haemostasis Sub-committee of the Nigerian Society for Haematology and Blood Transfusion, which has produced the first national venous thromboembolism guideline.
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