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. 2024 Jun 16;29(1):333.
doi: 10.1186/s40001-024-01934-0.

Variation of adverse drug events in different settings in Africa: a systematic review

Linda Nyame  1 , Yuhua Hu  2 , Hui Xue  2 , Emmanuel D K Fiagbey  3 , Xi Li  4 , Yong Tian  2 , Lijun Fan  2 , Wei Du  5
Affiliations

Variation of adverse drug events in different settings in Africa: a systematic review

Linda Nyame et al. Eur J Med Res. .

Abstract

Background: Adverse drug events (ADEs) represent challenges affecting Africa's healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs.

Objectives: We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa.

Methods: Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095).

Results: We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2-21.4%) and 74.2% (IQR: 54.1-90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5-9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6-56.1%) and 32.6% (IQR: 26.0-41.3%), respectively, with a median of 43.5% (IQR: 16.3-59.0%) and 12.4% (IQR: 7.1-28.1%) of ADEs being preventable in general and specific patients, respectively.

Conclusions: The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.

Keywords: Adverse drug events; Adverse drug reactions; Africa; Prevalence; Systematic review.

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Conflict of interest statement

The authors have no competing interests to declare that are relevant to the content of this article.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of the study selection process
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References

    1. Dixon-Woods M. Why is patient safety so hard? A selective review of ethnographic studies. J Health Serv Res Policy. 2010;15:11–16. doi: 10.1258/jhsrp.2009.009041. - DOI - PubMed
    1. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N Engl J Med. 1991;324(6):370–376. doi: 10.1056/NEJM199102073240604. - DOI - PubMed
    1. Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, et al. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ. 2019;366:l4185. doi: 10.1136/bmj.l4185. - DOI - PMC - PubMed
    1. Gallagher P, Lang PO, Cherubini A, Topinková E, Cruz-Jentoft A, Montero Errasquín B, et al. Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals. Eur J Clin Pharmacol. 2011;67(11):1175–1188. doi: 10.1007/s00228-011-1061-0. - DOI - PubMed
    1. Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, et al. Appropriate prescribing in elderly people: how well can it be measured and optimised? Lancet. 2007;370(9582):173–184. doi: 10.1016/S0140-6736(07)61091-5. - DOI - PubMed

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