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Warfarin anticoagulation in patients with cardiovascular disease in sub-Saharan Africa

IATI Identifier: GB-COH-RC000660-War-PATH

Published on IATI
  • date_range Jun 01, 2017
  • autorenew Implementation (Status)

The War-PATH NIHR Global Research Group is between the University of Liverpool and two low and middle income countries (LMICs), Uganda and South Africa. It will focus on a clinically important noncommunicable disease area which requires the use of anticoagulation. Anticoagulants, in particular warfarin, are used in these countries for the treatment of venous thromboembolism, rheumatic heart disease and prevention of strokes in patients with irregular heart rhythms (atrial fibrillation). Anticoagulation represents an unmet clinical need in Sub-Saharan Africa as patients either do not receive anticoagulation (because of difficulties in monitoring) or are poorly anticoagulated because of poor dosing guidelines. This results in potentially preventable morbidity and mortality which affects the poorer sectors of the population in particular. We have extensive expertise in the UK and EU of improving the use of warfarin through the development of novel dosing algorithms, which have now began incorporating genetic factors. By contrast, in our two collaborating partner countries, no good dosing algorithms exist, even those which only take into account clinical factors. The situation in these 2 countries is further complicated by the fact that there is a high prevalence of HIV and TB, which make anticoagulation harder because (a) they increase the risk of thrombosis, and (b) the drugs used for treatment interact with warfarin. Our research will focus on: (a) evaluating the quality of anticoagulant services in Cape Town and Kampala taking into account the indications, anticoagulant clinic set-up and quality of anticoagulation control; (b) recruiting patients currently on warfarin to identify clinical factors determining anticoagulation quality to develop a dosing algorithm; (c) a study to implement the clinical algorithm in the two sites; and (d) evaluating genes specific to the African population that can impact on anticoagulation control, and the development of novel genetic dosing algorithms. The work will be accompanied by education and training of the local workforce to improve local capability and capacity. We will also train 4 students to Masters level, and 2 post-doctoral researchers will be seconded to Liverpool to gain training in high-end genomics. We will also engage with regional health policy makers in both countries to develop the best pathways for implementing the research findings to improve anticoagulation care, for the benefit of patients, the local society and ultimately the economy. We will also work with technology companies to develop long-term cost-effective strategies to implement novel technologies that will allow for point-of-care testing of anticoagulation, and also of genetic markers.

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Participating Organisations

NIHR Government Funding
Makerere University Academic, Training and Research Implementing
University of Cape Town Academic, Training and Research Implementing
University Of Liverpool Academic, Training and Research Implementing
University of Bangor Academic, Training and Research Implementing

Transaction

Transaction Value Provider
Receiver
Type Date
21,697 GBP Provider N/A Receiver N/A Disbursement
date_range Jun 03, 2021
12,233 GBP Provider N/A Receiver N/A Disbursement
date_range Apr 20, 2021
181,306 GBP Provider N/A Receiver N/A Incoming Funds
date_range Mar 25, 2021
15,995 GBP Provider N/A Receiver N/A Disbursement
date_range Feb 04, 2021
14,266 GBP Provider N/A Receiver N/A Disbursement
date_range Jan 21, 2021
218,897 GBP Provider N/A Receiver N/A Incoming Funds
date_range Dec 01, 2020
11,435 GBP Provider N/A Receiver N/A Disbursement
date_range Oct 29, 2020
16,462 GBP Provider N/A Receiver N/A Disbursement
date_range Oct 23, 2020
82,321 GBP Provider N/A Receiver N/A Incoming Funds
date_range Oct 01, 2020
25,085 GBP Provider N/A Receiver N/A Disbursement
date_range Aug 07, 2020
14,779 GBP Provider N/A Receiver N/A Disbursement
date_range Jul 27, 2020
27,613 GBP Provider N/A Receiver N/A Disbursement
date_range Jun 19, 2020
32,839 GBP Provider N/A Receiver N/A Disbursement
date_range Jun 18, 2020
17,999 GBP Provider N/A Receiver N/A Disbursement
date_range Apr 24, 2020
142,567 GBP Provider N/A Receiver N/A Expenditure
date_range Mar 31, 2020
332,887 GBP Provider N/A Receiver N/A Incoming Funds
date_range Mar 24, 2020
24,258 GBP Provider N/A Receiver N/A Disbursement
date_range Feb 05, 2020
113,509 GBP Provider N/A Receiver N/A Expenditure
date_range Dec 31, 2019
222,286 GBP Provider N/A Receiver N/A Incoming Funds
date_range Dec 17, 2019
26,274 GBP Provider N/A Receiver N/A Disbursement
date_range Dec 11, 2019
24,082 GBP Provider N/A Receiver N/A Disbursement
date_range Oct 19, 2019
23,327 GBP Provider N/A Receiver N/A Disbursement
date_range Oct 07, 2019
76,295 GBP Provider N/A Receiver N/A Incoming Funds
date_range Oct 01, 2019
110,590 GBP Provider N/A Receiver N/A Expenditure
date_range Sep 30, 2019
19,323 GBP Provider N/A Receiver N/A Disbursement
date_range Jul 31, 2019
23,329 GBP Provider N/A Receiver N/A Disbursement
date_range Jul 30, 2019
92,117 GBP Provider N/A Receiver N/A Expenditure
date_range Jun 30, 2019
83,904 GBP Provider N/A Receiver N/A Incoming Funds
date_range Jun 27, 2019
218,080 GBP Provider N/A Receiver N/A Incoming Funds
date_range Apr 02, 2019
92,775 GBP Provider N/A Receiver N/A Expenditure
date_range Mar 31, 2019
20,546 GBP Provider N/A Receiver N/A Disbursement
date_range Mar 31, 2019
27,492 GBP Provider N/A Receiver N/A Disbursement
date_range Feb 04, 2019
14,524 GBP Provider N/A Receiver N/A Disbursement
date_range Jan 30, 2019
130,965 GBP Provider N/A Receiver N/A Expenditure
date_range Dec 31, 2018
207,960 GBP Provider N/A Receiver N/A Incoming Funds
date_range Dec 27, 2018
18,259 GBP Provider N/A Receiver N/A Disbursement
date_range Dec 07, 2018
17,334 GBP Provider N/A Receiver N/A Disbursement
date_range Nov 13, 2018
18,045 GBP Provider N/A Receiver N/A Disbursement
date_range Oct 11, 2018
117,672 GBP Provider N/A Receiver N/A Incoming Funds
date_range Oct 02, 2018
69,988 GBP Provider N/A Receiver N/A Expenditure
date_range Sep 30, 2018
14,407 GBP Provider N/A Receiver N/A Disbursement
date_range Aug 08, 2018
143,397 GBP Provider N/A Receiver N/A Incoming Funds
date_range Jul 03, 2018
69,692 GBP Provider N/A Receiver N/A Expenditure
date_range Jun 30, 2018
2,446 GBP Provider N/A Receiver N/A Disbursement
date_range Jun 12, 2018
5,859 GBP Provider N/A Receiver N/A Disbursement
date_range Jun 11, 2018
9,048 GBP Provider N/A Receiver N/A Disbursement
date_range Apr 23, 2018
150,399 GBP Provider N/A Receiver N/A Expenditure
date_range Mar 31, 2018
96,326 GBP Provider N/A Receiver N/A Incoming Funds
date_range Mar 27, 2018
54,850 GBP Provider N/A Receiver N/A Incoming Funds
date_range Mar 01, 2018
50,000 GBP Provider N/A Receiver N/A Incoming Funds
date_range Oct 12, 2017

Budget

3,183,908 USD
  • 201,176 GBP (Valued at Mar 31, 2018)
    date_range Jun 01, 2017 - Mar 31, 2018
  • 687,109 GBP (Valued at Mar 31, 2019)
    date_range Apr 01, 2018 - Mar 31, 2019
  • 715,372 GBP (Valued at Mar 31, 2020)
    date_range Apr 01, 2019 - Mar 31, 2020
  • 482,524 GBP (Valued at Apr 23, 2020)
    date_range Apr 01, 2020 - Mar 31, 2021
  • 387,079 GBP (Valued at Jul 19, 2021)
    date_range Apr 01, 2021 - Feb 28, 2022
access_time Updated on Oct 28, 2021 19:44:53