Introduction Thrombophilia describes conditions that predispose individuals to increased blood clotting and includes conditions such as deep vein thrombosis and pulmonary embolism. Thrombophilia is associated with high morbidity and mortality rates, and is commonly treated by warfarin anticoagulation. However, warfarin may cause both bleeding and clotting episodes if the therapy is not monitored and managed effectively. Objectives The main objective of this study was to assess the effectiveness of warfarin monitoring systems on thrombophilic patients at a major hospital in Zimbabwe. Material and Methods A clinical and laboratory prospective and retrospective study was performed on patients who had been on warfarin therapy for at least 1 year. Questionnaires were administered to participants on warfarin from outpatients clinics at Parirenyatwa Group of Hospitals. Their international normalized ratio (INR) results were also accessed from the laboratory information system and captured in the Epi info and Microsoft Excel for analysis. Results Fifty questionnaires were administered and 47 (94%) participants responded adequately. Twenty-nine (61.1%) participants on warfarin were females. The majority of them were elderly and in the 31 to 40 age groups. Eighteen (38.3%) participants missed their medication at some point, while 12 (25.5%) had warfarin overdose. Sixteen (34%) and 11 (23.4%) admitted to taking alcohol and smoking, respectively, while on warfarin. Thirty-five (74.5%) did not change their medication nor were advised on the right diet. Thirty-four (72.3%) had appointments set after every month. Some participants indicated that they had symptoms of both clotting and bleeding. There were statistically significant differences (p < 0.0001) between INRs for 3 monthly intervals from the initiation of warfarin therapy. Conclusion Women and the elderly formed the majority of the patients on warfarin, indicating gender and advanced age susceptibility to thrombophilia, respectively. The effectiveness of the warfarin monitoring systems appeared to be hampered by lack of a coordinated system that adequately monitors anticoagulant therapy in the country.

With 1 figure in the text) Baseline haematological data were obtained through routine analyses of blood samples from 31 wild black rhinoceroses captured in the Mana Pools National Park, Zimbabwe. Additional tests showed that the haemoglobin of this population is unstable; this observation helps explain the attacks of acute intravascular haemolysis documented in captive animals.

Background: Haematological malignancies are defined as primary cancers of blood cells. Leukaemia constitutes more than fifty-five percent of haematological malignancies. The epidemiology of leukaemia in Zimbabwe is currently unknown. Aim: To investigate the incidence of leukaemia in Zimbabwe during a ten year period from 2004 to 2013. Objective: To understand the latest epidemiology of leukaemia in the country in order to effectively manage the disease and inform policy makers. Methods: A ten year cross sectional retrospective epidemiological study was carried out on 601 reported cases of leukaemia registered at the Zimbabwe National Cancer Registry from 1January 2004 to 31 December 2013. Results: More males (59%) had leukaemia than female (41%). Children (28%) developed leukaemia more than the adults. Chronic myelogenous leukaemia (29%) was the most common type of leukaemia, followed by acute myeloid leukaemia (24%), acute lymphoblastic leukaemia (18%), unclassified (17%) and chronic lymphocytic leukaemia (12%). Harare had the highest and Matebeleland South the lowest reported cases of leukaemia. Unemployed adults had the highest incidence followed by children. Conclusion: Zimbabwe has an increasing burden of the leukaemia compared to developed countries. A high proportion of leukaemia was not classified, making it difficult to come up with reliable subtypes of the disease. More men and children were affected than women and the elderly respectively. The distribution of types of leukaemia was consistent with literature information. Unemployed people appeared to have a higher risk for developing leukaemia in Zimbabwe.

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Background and objectives: Massive blood transfusion is defined as transfusion approximating or exceeding a patient's total blood volume (5-6 litres in adults) within 24-hours. This procedure is used to manage severely anaemic and bleeding patients. Negative outcomes associatedwith acidosis, hypothermia and coagulopathy may result. The study was carried out to review the management of massive transfusion in Zimbabwe.Materials and methods: A 4-year retrospective clinical laboratory-based study was carried out on patients who had massive blood transfusionat a Zimbabwean hospital, from January 2014 to December 2017. Data was collected from patients’ hospital records after permission from thehospital director.Results: Of the 180 patient records, 145 (80.6%) were from female and 35 (19.4%) from male patients. Massive blood transfusion was done mostly on obstetric patients. Full blood count was the most commonly requested laboratory test, with 155 (86%) requests. Some of the patients had severe anaemia. Routine coagulation tests were significantly abnormal. All patients received packed red cells during the first 24 hours, followed by fresh frozen plasma (57.8%). Platelets, cryoprecipitate and whole blood were infrequently transfused (22%, 3% and 2% respectively). The mortality rate was 25.6% within 24 hours after transfusion. Transfusion of packed red cells alone was significantly associated with mortality (p<0.001) which increased significantly with the use of high numbers of packed red cell units.Conclusion: Massive blood transfusion is associated with a high mortality rate in Zimbabwe. Transfusion of packed red blood cells alone resulted in highest mortality. There was an insufficient use of laboratory tests to monitor massive blood transfusion. This potentially can be addressed by establishing a national massive transfusion protocol for Zimbabwe. French Title: Une revue de la transfusion sanguine massive et de ses syndromes associés au Zimbabwe Contexte et objectifs: La transfusion sanguine massive est définie comme une transfusion se rapprochant ou dépassant le volume sanguin total d'un patient (5-6 litres chez l'adulte) dans les 24 heures. Cette procédure est utilisée pour gérer les patients gravement anémiques et hémorragiques. Des résultats négatifs associés à l'acidose, l'hypothermie et la coagulopathie peuvent en résulter. L'étude a été réalisée pourexaminer la gestion de la transfusion massive au Zimbabwe.Matériel et méthodes: Une étude rétrospective clinique en laboratoire de 4 ans a été menée sur des patients ayant subi une transfusion sanguine massive dans un hôpital du Zimbabwe, de Janvier 2014 à Décembre 2017. Les données ont été collectées à partir des dossiers des patients de l'hôpital après autorisation du Directeur de l'hôpital.Résultats: Sur les 180 dossiers de patients, 145 (80,6%) provenaient de femmes et 35 (19,4%) de patients de sexe masculin. Une transfusion  sanguine massive a été effectuée principalement sur des patientes obstétricales. L'hémogramme complet était le test de laboratoire le plus  demandé, avec 155 (86%) demandes. Certains patients souffraient d'anémie sévère. Les tests de coagulation de routine étaient significativement  anormaux. Tous les patients ont reçu des concentrés de globules rouges au cours des 24 premières heures, suivis de plasma frais congelé (57,8%). Les plaquettes, le cryoprécipité et le sang total ont été rarement transfusés (22%, 3% et 2% respectivement). Le taux de mortalité était de 25,6%  dans les 24 heures suivant la transfusion. La transfusion de concentrés de globules rouges seule était significativement associée à la mortalité (p<0,001) qui augmentait significativement avec l'utilisation d'un nombre élevé d'unités.Conclusion: La transfusion sanguine massive est associée à un taux de mortalité élevé au Zimbabwe. La transfusion de concentrés de globules rouges seule a entraîné la mortalité la plus élevée. Les tests de laboratoire étaient insuffisants pour surveiller les transfusions sanguines massives. Cela peut potentiellement être résolu en établissant un protocole national de transfusion massive pour le Zimbabwe