THROMBOSIS IN AFRICA: PAST, PRESENT AND FUTURE

ThrombosisThrombosis in Africa:Africa: Past,Past, PresentPresent andand Future FebruaryFuture 28th - March 1st, 2018 Four Points Sheraton Hotel, Hurlingham,February 28th - March - 1st, 2018 Four Points Sheraton Hotel, Hurlingham, Nairobi - Kenya

PROGRAMME 1 THROMBOSIS IN AFRICA: PAST, PRESENT AND FUTURE

Day One: Wednesday, February 28, 2018 TIME EVENT 8:45 AM Registration 9:00 AM THEME OF SESSION: STATUS OF THROMBOSIS IN AFRICA Dr M. D. Maina - Chair of session

What is the most reasonable approach to diagnose and treat bleeding disorders in country/region and beyond? What are the next steps to improve management? Prof Malkit Riyat - Kenya

The presentation will give regional experiences, perspectives and how to move forward 9:25AM Overview of The New Anticoagulants Dr Anne Mwirigi - Kenya 9:50AM Thrombosis Prophylaxis in country/region Dr Harun Otieno - Kenya

The presentation will give the country/regional perspective in prophylaxis and treatment of thrombosis, including developments in developing national guidelines 10:15 AM QUESTIONS FOR SESSION SPEAKERS 10:40 AM REFRESHMENTS 11:10 AM THEME OF SESSION THROMBOTIC DISORDERS Dr Anne Mwirigi - Chair of session 11:35 AM Diagnosis of Thrombosis and Pulmonary Embolism in Country/region Current State Dr Anders Barasa - Kenya

Thrombosis in Sickle Cell Disorder Dr. Elizabeth Kagotho - Kenya

Participants will be presented with local country specific aspects in diagnosis and presentation of Thromboses and pulmonary embolism in country

The presentation will focus on emerging paradigm shift relating procoagulant factors such as RBC TF decryption, PS expression, endothelial vWF release and microparticles in aetiology of thrombosis associated with Sickle cell crisis. 12:00 PM Inherited Thrombophilia rational for not testing Dr David Rabbolini - Australia

Participants will gain an insight into thrombophilia risk factors, diagnostic criteria for testing, utility of information and when not order tests

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Day One: Wednesday, February 28, 2018 TIME EVENT 12:25 PM QUESTIONS FOR SESSION SPEAKERS 1:00 PM LUNCH 2:00 PM THEME OF SESSION: PHARMACOLOGY OF VENOUS THROMBOSIS Dr Alice Kanyua - Chair of session

Overview of The Old Anticoagulants Dr M. D. Maina - Kenya 2:30 PM What are the gaps in thrombosis and haemostasis research in Kenya and African region? Dr Nancy Okinda - Kenya 3:00 PM Oral presentations 3:30 PM Building international networks to improve patient care in Thrombosis and Hemostasis. Prof Steve Kitchen - UK 4:00 PM NETWORKING EVENING

Day Two: Thursday, March 1, 2018 TIME EVENT 8:45 AM Registration 9:00 AM THEME OF THE SESSION: APPROACH TO BLEEDING DISORDERS Dr Gordon Ogweno - Chair of session 9:25AM How to approach a patient with a history of increased bleeding tendency? Focus on plasmatic disorders. Prof Steve Kitchen - UK This presentation will critically look into strengths and pitfalls of routine global assays of coagulation in the context of traditional and emerging concepts of coagulation. 9:50AM How to approach a patient with a history of increased bleeding tendency? Focus on von Willebrand disease Prof Johnny Mahlangu - RSA The presentation will focus on phenotypic tests available in the diagnosis of vWD. Participants will be provided with guidance on application and interpretation of these tests as a basis for rational therapy 10:15 AM How to approach a patient with a history of increased bleeding tendency? Focus on platelet disorders Dr David Rabbolini - Australia This presentation will provide overview of principles of platelet function testing in the context of clinical practice. It will present typical light transmission aggregometry (LTA) patterns in different disorders as well as choice of assay in in investigation of bleeding disorders.

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Day Two: Thursday, March 1, 2018 TIME EVENT 10:40 AM QUESTIONS FOR SESSION SPEAKERS 11:05 AM REFRESHMENTS 11:30 AM THEME OF SESSION: DIAGNOSIS OF BLEEDING DISORDERS Dr Nancy Okinda, Chair of session Diagnosis and Treatment of Inherited Bleeding Disorders Dr Valarie Magutu-Kenya The presentation will present data in African context with special focus in the Kenyan situation. The content will cover racial and ethnic differences in clinical presentation and interpretation of laboratory data. 11:55 AM What are micro particles? Its relevance to thrombosis and cardiovascular disorders Dr Gordon Ogweno-Kenya

The presentation will give an overview of science of blood microparticles, identification and relevance in haemostatis and thrombosis especially in cardiovascular disorders. 12:15 PM Womens’ health issues in hemostasis – bleeding Dr Patricia Muthaura - Kenya This presentation will give unique issues in bleeding disorders in women such as PPH, vWD and platelet disorders with regard to pregnancy complications, menstrual health and potential impact on and risk to the baby 12:40 PM QUESTIONS FOR SESSION SPEAKERS 1:00 PM LUNCH 2:30 PM THEME OF SESSION: ROLE OF INFECTION IN COAGULOPATHIES Dr Anne Barasa - Chair of session Malaria related coagulopathy-lessons learnt from vascular biology Dr Gordon Ogweno - Kenya The presentation will focus on parasite-endothelial interaction, placenta as a special case. It will give highlights of emerging concepts relating vWF, microparticles and platelets in the pathophysiology of cerebral malaria 3:00 PM HIV related coagulopathy-Role of platelets and endothelial interactions Dr Rael Onjula - Kenya Participants will gain an insight into HIV virus-platelets-endothelial triad in the pathophysiology of DVT, stroke and heart attacks. It will present current understanding of TTP in the background of HIV and HAART 3:30 PM QUESTIONS FOR SESSION SPEAKERS

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Day Two: Thursday, March 1, 2018 TIME EVENT 4:00 PM MEET THE EXPERTS CHAIR Dr Beatrice Kabera - Kenya Meet the Experts (mentored by international experts)

4:30 PM Tropical disease, vWD or platelets, women’s health The international participants will discuss with the delegates in small groups real life cases from the participants experience

5:00 PM REFRESHMENT/SOCIAL EVENT/MEET THE EXPERTS

Conference speakers

Dr. Joseph M.D. Dr. Gordon Ogweno, Maina RCP ECLIN MB:ch.B: M.Med Consultant physician (Anaesth); PhD /haematology in Dr. Gordon is a Kenyatta National medical doctor Hospital. He is the and consultant founding Chairman of KSTH, member of anesthesiologist. He is currently the International Society Haemostasis and chairman department of Medical Thrombosis (ISTH) European Society Physiology at School of Heamatology (EMA) and American of Medicine. society of Haematolgy (ASH). Dr Maina He graduated with MBchB and M.Medicine has special interest in Haemostasis and form the and PhD thrombosis. in Medical Physiology (Thrombosis and Haemostasis) from Kenyatta Dr. Peter Waweru, University in 2016. He has had training Bpharm; MSC; PhD in Thromboelatography at University He is a lecturer in of Cape Town in South Africa, Platelet the department of aggregometry and Thrombin generation Medical Physiology at University of Maastricht. He is a School of Medicine, member of ISTH since 2012 sitting in University of Nairobi. He is currently the the subcommittees of Peroperative treasurer of KSTH. His research interests Haemotasis and platelets sub committes. are in the evaluation of traditional He is the founding Secretary General of medicines used in the management of KSTH. His research interests include VWF bleeding conditions and effects of animal and paltelets in HIV and adolescents with venom on coagulation. menorrhagia.

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Conference speakers

Anne Mwirigi, BSc, Dr. Elizabeth MBChB, MRCP, Kagotho FRCPath Dr.Elizabeth Kagotho Dr Mwirigi graduated is a medical doctor with a MBChB degree with Post graduate from the University training in Clinical of Glasgow in 2002, having also a pursued Pathology at the Aga Khan University an intercalated degree during her medical Hospital Nairobi ,2016. She is currently training and earning her Bsc (MedSci) in a Clinical Pathologist at the Aga Khan 2000 from the same university. University hospital, Nairobi.

After 4 years of Internal Medicine training She is a member of the International in Glasgow and gaining Membership of the Society of thrombosis and haemostasis Royal College of Physicians in 2007, she (ISTH) and one of the founding members commenced her career in Hematology as of the Kenya society of thrombosis and a Senior House Officer at King’s College haemostasis (KSTH). Hospital in London. She thereafter became a Specialist Registrar at Guy’s She has a interest in Clinical Flow and St Thomas’ NHS Trust in 2009 and a cytometry for the diagnosis and Acute Fellow of the Royal College of Pathologist Leukemia and LPD’s and was trained on in Hematology in 2012. the same at the Toronto General Hospital , Toronto Canada. She also has a keen She obtained her Certificate of Completion interest in thrombosis and haemostasis of Training (CCT) in 2014, and later took up and is currently working on a number of consultant position for a period of two and studies on the same. a half years at both Guy’s and St Thomas’ and King’s College Hospitals. Steve Kitchen, PhD, FIBMS Dr. Mwirigi is an active member of various Current positions local and international hematological Professor Steve societies. Kitchen is the Lead Clinical With more than 10 years’ experience Scientist , Dept of Coagulation, Sheffield in all aspects of benign and malignant Haemophilia and Thrombosis Centre, haematology, including sickle cell disease, Sheffield Teaching Hospitals. Centre is bleeding and clotting disorders, myeloid designated an International Haemophilia and lymphoid malignancies, Dr Mwirigi Training Centre by World Federation of is passionate about delivering a high Haemophilia. standard of care to her patients.

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He is also the Scientific Director, UK Anders Barasa, MD, National External Quality Assessment PhD, Consultant Scheme for Blood Coagulation (2001 to Cardiologist date). Dr. Anders Barasa obtained his Professor Kitchen is the Director WFH undergraduate International External Quality Assessment and postgraduate degrees and training Schemes for Blood Coagulation (2012 to from the University of Copenhagen date) and Sahlgrenska University Hospital in Sweden respectively. He defended his Current committee and working group PhD-thesis at University of Gothenburg. memberships • 1992 to date - Steering committee UK He is currently admitted to the onsite NEQAS Blood Coagulation. 2-year Postgraduate Heart Failure • 1993 to date - World Federation of programme run by ESC/HFA, the ESC Haemophilia, Laboratory Sciences Heart Academy and certified by the Committee University of Zurich. • 1995 to date - SSC Working Group on Diagnostic Standards Dr. Barasa has since 2014 been in Kenya • 2008 to 2015 - Associate Editor, and is currently in full-time faculty at Aga Seminars in Haemostasis and Khan dept of Cardiology where he is Lead Thrombosis for research and outpatient care. • 2009 to 2016 - ISTH Educational Committee His research interests include heart • 2013 to date - Associate editor JTH failure in the young, mobile health, registries, cardiac imaging and heart Awards disease in pregnancy. • 2008 Inga Marie Nilsson Award, World Federation of Haemophilia His areas of expertise are advanced • Bi-annual International award to a WFH echocardiography, hypertension, venous health care professional volunteer for thromboembolism and heart failure. services to the field of haemophilia care Dr. Barasa has been a main protagonist in • 2014 Lifetime Achievement Award, pushing for a Kenyan run heart registry. Anticoagulation In Practice His voluntary work includes work in the • Annual UK award to a health care Scientific Committee of the national professional involved in the field of Cardiac Society and consultancy with the anticoagulation. ministry of health. • 2015 Benend Houwen Memorial Lecture ISLH Chicago

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Dr Nancy Okinda, Professional associations Assistant Professor • Member, Kenya Association for Clinical Pathologists Education • Member, College of Pathologist for East Nancy has a Master Central and Southern Africa of Medicine in Clinical • Member, Kenya Medical Association Pathology Aga Khan University, 2009 and a Bachelor of Medicine Bachelor of Surgery Professor Malkit University of Nairobi, 2004 Singh Riyat MBChB (UON), Training MRCPath (UK), • Subspecialty training in FRCPath (UK), Hematopathology University of Cape FCPath ECSA Town 2011-2012 Professor Malkit is an Associate Professor of Haematology and Blood Transfusion – Current areas of teaching Departments of Medicine and Pathology • Hematology/immunology Aga Khan University Hospital, Nairobi

Research interests Teaching positions held • Venous thromboembolism • Jan 1989 – Nov 1990 - Lecturer • Phenotyping of red cell antigens in the in Haematology, Department of Kenyan population Haematology and Blood Transfusion, • Vitamin D metabolism University of Nairobi • Abacavir hypersensitivity B5701 • Dec 1990 - April 1992: Senior Lecturer, Department of Haematology and Blood Experience Transfusion, University of Nairobi • Full time Faculty and Program Director, • 2005 – 2012: Program Director, Clinical Department of Pathology Aga Khan Pathology AND Anatomic Pathology- University in Nairobi Department of Pathology, Aga Khan • Instructor, Clinical Pathology, Aga Khan University Hospital – Nairobi University Hospital, Nairobi • January 2005 - Present: Assistant • Medical Officer, Aga Khan University Professor of Haematology - Department Hospital, Nairobi of Pathology, Aga Khan University • Medical Officer, Gertrud Garden Hospital – Nairobi Children Hospital • 2014 – Present: External Examiner • Medical Officer, Pumwani Maternity • Department of Human Pathology, Hospital University of Nairobi • January 2016 – Present: Associate Professor of Haematology – Department of Pathology, Aga Khan University Hospital

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Professor Malkit has more than 40 AfricaSTEMI Live and the Thrombosis publications in peer reviewed journals, Management in Practice (TMiP) . several oral presentations at international These are all regular professional conferences and regular invited speaker medical education fixtures for African and at medical conferences. International Doctors.

Research intrests: His research interests include acute • Chronic Myeloid Leukaemia myocardial infarction , Venous • Multiple Myeloma thromboembolism as well as • Chronic Lymphocytic Leukemia looking innovative healthcare solutions • Malignant Lymphomas in resource limited settings. He enjoys fitness activities and running, music, Dr Harun Otieno traveling with his family in his free time. Dr. Harun Otieno is an Interventional He is the current Vice Chair of Cardiologist with the Kenya Society of Thrombosis & Africa Heart Hemostasis & the Vice President for the Associates. PASCAR, East Africa Region. Currently based at the Aga Khan University Hospital, Nairobi & MP Shah Dr David Rabbolini Hospital, Kenya, BSc MBBCh (Witw.), FRACP, FRCPA Dr. Otieno graduated from the University of Nairobi, Kenya and has been trained in Dr. Rabbolini is a Internal Medicine/Cardiology, haematologist at Interventional Cardiology at Pittsburgh, The Royal North Shore Hospital, Sydney, USA. He worked in Texas, until 2009 Australia. He has a broad interest in when he returned back home to Kenya to thrombosis and haemostasis with recent develop the highly successful Cath Lab completion of a PhD at the Northern Blood and Cardiac program at the Aga Khan Research Centre, University of Sydney University Hospital Nairobi. He has also in 2017, and a fellowship in Transfusion been instrumental in the design and and Haemostasis at St Vincent’s Hospital, development of cardiology services at the Sydney in that year. MP Shah Hospital Cath Lab. His research interests include the utilization of induced pluripotent He is very active in professional medical cells for the investigation of inherited education and hosts several meetings a thrombocytopenia caused by mutations year both in Kenya and internationally. in hematopoietic transcription factors, Dr Otieno organizes several medical as well as the use of next generation meetings including The Aga Khan Annual sequencing platforms for the investigation Heart Symposium, AfricaPCR, CSI Africa, of these disorders.

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Dr Rabbolini’s current focus is the including the International Society of co-ordination of a Sydney platelet Thrombosis and Haemostasis and the collaborative group whose aim is to Thrombosis and Haemostasis Society of improve the diagnosis of inherited Australia and New Zealand and was the platelet disorders in the region. He holds proud recipient of the ASTH scientific memberships with professional societies medal in 2015 and runner-up in 2016.

About Kenya Society for Thrombosis and Haemostasis (KSTH)

Kenya Society for Thrombosis and 4. Hold periodic research seminars and Haemostasis (KSTH) is the Kenyan meetings affiliate of the International Society for Thrombosis and Haemostasis (ISTH). Vision In common with its apex organization To be the leading scientific organization the mission of KSTH is a nonprofit in Kenya in the promotion of research, organization that aims to advance the diagnosis, treatment and prevention of understanding, diagnosis, prevention and thrombotic and bleeding disorders. treatment of thrombotic and bleeding disorders. History This society was begun as an informal In pursuit of these afore stated goals the working group composed of physicians organization aims to leverage its diverse and basic scientists involved in the membership drawn from both the basic esoteric field of coagulation. This nuclear sciences, paramedical and medical group of individuals would then organize professions to initiate and sustain the a scientific seminar at Hadassah hotel following activities: in October 13th 2015 to coincide with the 1. Create awareness among both the lay world thrombosis day. and professional populations via public education and CME activities At the end of the meeting it was then 2. Support research activities as well as decided to establish the Kenya Society capacity building activities around these For Thrombosis and Haemostasis as one research activities to ensure production of the resolutions of the meeting. The of world class but locally relevant society was duly registered in April 2016 research. and was formally affiliated to ISTH soon 3. Participate in the preparation of afterwards. relevant clinical guidelines to improve the management of thrombotic and A secretariat was then established bleeding disorders thereby improving at.Elgon court, block B door 1 along Ralph patient outcomes. Bunche road in upper hill Nairobi.

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The interim office bearers of the with a number of corporate partners e.g. organization are: Bayer and Astra Zeneca. 1. Dr M. D. Maina - chairman The organization has also become 2. Dr. Harun Otieno- vice chairman affiliated with a patients group consisting 3. Dr. Gordon Ogweno- Secretary General of survivors of venous thromboembolic 4. Dr. Elizabeth Kagotho- deputy Secretary disease and it is hoped that this General collaboration will give rise to joint public 5. Dr. Peter Waweru – Treasurer awareness building events. 6. Dr Nancy Okinda Organizing Secretary Membership Activities Membership is open to all scientists, The society has to date held 2 very physicians as well as students interested successful seminars and workshops on in the field of haemostasis. world thrombosis day in 2015 at Hadassah hotel and a much larger meeting at The membership reregistration is southern sun hotel in 2016. Kshs. 7,500/- and an annual subscription The organization aims to expand its CME of Kshs. 5,000/- for more details please activities in 2017/2018 in collaboration visit www.ksth.co.ke

Conference sponsors

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For more information please contact the Conference secretariat: E-mail: [email protected] Webiste: www.ksth.co.ke

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