{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T08:37:18Z","timestamp":1792917438842,"version":"4.5.0"},"reference-count":51,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Appl Thromb Hemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immune thrombocytopenia (ITP) is an acquired immune-mediated platelet disorder. Most evidence informing its diagnosis and management comes from high-income settings as transferability to low- and middle-income countries (LMIC) may not be possible. We conducted a systematic review to characterise adult ITP in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted this systematic review in accordance with PRISMA guidance. Studies reporting adult ITP in LMICs were included if they provided data on epidemiology, infections, first- or second-line treatment, or patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty studies were included in this review. ITP often presented in younger adults than typically reported in high-income settings. Secondary ITP accounted for a substantial proportion of cases. Infectious associations, particularly\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      , hepatitis C virus, and HIV, were important contributors to this. Corticosteroids remained the common first-line therapy but was used for prolonged periods. Limited access to newer agents meant that second-line management frequently relied on azathioprine, dapsone, anti-D or splenectomy. Patient-reported outcome data suggested substantial effects on daily activities, work, emotional wellbeing and treatment burden. Most studies, however, were single-centre observational reports and were judged to be at moderate risk of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ITP in LMICs is shaped by distinct factors. Resource-specific diagnostic and treatment frameworks are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10760296261480917","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:13:58Z","timestamp":1792685638000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Immune Thrombocytopenia in Low- and Middle-Income Countries: A Systematic Review"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0808-8779","authenticated-orcid":false,"given":"Gerard","family":"Gurumurthy","sequence":"first","affiliation":[{"name":"The Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust"},{"name":"Cambridge University Hospitals NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Kropidlowska","sequence":"additional","affiliation":[{"name":"Medical University of Gdansk"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heghine","family":"Khachatryan","sequence":"additional","affiliation":[{"name":"Yeolyan Hematology and Oncology Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Ogweno","sequence":"additional","affiliation":[{"name":"Kenyatta University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Nwagha","sequence":"additional","affiliation":[{"name":"University of Nigeria Teaching Hospital Ituku-Ozalla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jecko","family":"Thachil","sequence":"additional","affiliation":[{"name":"Department of Haematology"},{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-05-578336"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2009.01247.x"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07615.x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2017.05.010"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-011-0791-1"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14915"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2009.08.004"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.237"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000966"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2019000812"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpth.2025.103323"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2016.1143923"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/10245332.2016.1148845"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12288-025-02119-3"},{"issue":"1","key":"e_1_3_4_17_2","first-page":"99","article-title":"Immune thrombocytopaenic purpura: 11-year experience in Ile-Ife, Nigeria","volume":"30","author":"Salawu L","year":"2001","unstructured":"Salawu L, Durosinmi MA. 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