Outcomes, challenges and prospects of emicizumab prophylaxis in Sub-Saharan Africa – Insights from the Tanzanian experience
Rebbecca Wughanga Mwakichako
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Rajabu Hussein Mnkugwe
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Clara Chamba
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Peter Kunambi
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, , , Michelle Munroe
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Gladys Kaaya
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Mwashungi Ally
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Ahlam Nasser
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, William Mawala
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Magdalena Lyimo
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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, Johnny Mahlangu
University of the Witwatersrand JohannesburgJohannesburg, South Africa
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and Stella Rwezaula
Muhimbili University of Health and Allied SciencesDar es Salaam, Tanzania
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Mar 19, 2025
About this article
Article Category: Clinical Research
Published Online: Mar 19, 2025
Page range: 15 - 22
DOI: https://doi.org/10.2478/jhp-2025-0005
Keywords
© 2025 Rebbecca Wughanga Mwakichako et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1.
Figure 2:
Sociodemographic and clinical characteristics of study participants
| Below 5 years | 14 | 25.5% |
| 5–18 years | 34 | 61.8% |
| Above 18 years | 7 | 12.7% |
| 8 (4,14) | ||
| Dar es Salaam | 28 | 50.9% |
| Outside Dar es Salaam | 27 | 49.1% |
| Severe (<1%) | 28 | 50.9% |
| Moderate (1–5%) | 22 | 40.0% |
| Mild (6–40%) | 4 | 7.3% |
| Unknown | 1 | 1.8% |
| Present | 19 | 34.6% |
| Absent | 36 | 65.4% |
| 8(5,16) | ||
| Present | 19 | 34.6% |
| Absent | 36 | 65.4% |
Association between sociodemographic and clinical characteristics and spontaneous bleeding
| < 5 | 1 (7.1%) | 13 (92.9%) | < 0.0001 | Ref | ||
| 5–18 | 5 (15.2%) | 28 (84.8%) | 2.12 | 0.27–16.54 | 0.473 | |
| >18 | 5 (83.3%) | 1 (16.7%) | 11.67 | 1.71–79.76 | 0.012 | |
| Mild | 1 (25.0%) | 3 (75.0%) | 0.885 | Ref | ||
| Moderate | 4 (18.2%) | 18 (81.8%) | 0.73 | 0.11–4.94 | 0.744 | |
| Severe | 6 (23.1%) | 20 (76.9%) | 0.92 | 0.15–5.79 | 0.932 | |
| Adherence | 6 (14.6%) | 35 (85.4%) | 0.098 | 0.35 | 0.13–0.95 | 0.040 |
| Non-adherence | 5 (41.7%) | 7 (58.3%) | Ref | |||
| Dar-es-Salaam | 5 (19.2%) | 21 (80.8%) | 1.000 | Ref | ||
| Outside Dar-es-Salaam | 6 (22.2%) | 21 (77.8%) | 1.16 | 0.40–3.33 | 0.789 | |
| Exemption | 0 (0.0%) | 1 (100.0%) | 1.000 | 0.80 | 0.68–0.95 | 0.010 |
| Insured | 7 (23.3%) | 23 (76.7%) | 0.99 | 0.80–1.22 | 0.900 | |
| Private | 2 (25.0%) | 6 (75.0%) | 1.00 | 0.75–1.34 | 1.000 | |
| Public (cost sharing) | 4 (25.0%) | 12 (75.0%) | Ref | |||