Practice Of Prothrombin Time Activated Partial Thromboplastin Time And Mixing Test In Public Hospitals Of Addis Ababa Ethiopia From March - June 2016

Background: Coagulation tests are vital to the diagnosis, treatment as well as management ofrnbleeding and hypercoagulability disorders. Inappropriate performance of coagulation tests, suchrnas the prothrombin time (PT), activated partial thromboplastin time (aPTT) and mixing testrncontributes to coagulation and bleeding complications including death. Practice of coagulationrntests is not well documented in resource limited settings like Ethiopia.rnObjective: To assess the practice of PT, aPTT and Mixing test in public hospitals of AddisrnAbaba from March - June 2016.rnMethodology: A prospective hospital based cross-sectional study was conducted from March –rnJune 2016 in all the 13 public hospitals of Addis Ababa. Standard questionnaires and checklistsrnwere used as a tool to investigate the practice of PT, aPTT and mixing test in the respectivernhospitals. On site assessment was carried out using a checklist. Questionnaires were used torninterview all laboratory professionals working in hemostasis section during the data collectionrnperiod. Mixing tests were performed at Tikur Anbessa Specialized Hospital (TASH) on 40rnplasma samples with prolonged PT/aPTT to demonstrate its usefulness and establish therntechnique in this premier referral and teaching hospital of the country. Data was entered andrnanalyzed using SPSS version 21 employing descriptive statistics such as frequency and mean.rnResult: Of all the 13 public hospitals in Addis Ababa, only 4 were performing either of the tworncoagulation tests. The performance of PT/aPTT tests was irregular among the 4 hospitals and didrnnot comply with some SOPs. The results of this study indicate that the laboratories do not followrncertain testing guidelines. None of the hospitals perform mixing test. Out of the 40 patients forrnwhom mixing test was performed, 18 had a corrected mixing test results, suggesting factorrndeficiency while 22 had no correction suggesting presence of inhibitors.rnConclusion: The practice of PT/aPTT tests in the public hospitals of Addis Ababa is insufficient.rnRegardless of the vital role the mixing tests plays in the diagnosis, treatment and follow up ofrnpatients with coagulopathy, it is not performed in any one of the public hospitals and none of thernlaboratory professionals had the knowledge of it. This warrants efforts in establishing the test atrnleast at TASH.rnKey words: Coagulation, PT, aPTT, Mixing Test, Hemostasis, public hospitals

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