Specifically, rivaroxaban may not be safer than warfarin in sub-Saharan Africa as many sub-Saharan patients also receive P-glycoprotein and CYP3A4-modulating drugs for tuberculosis and HIV, drugs which have been reported to attenuate rivaroxaban’s advantage in terms of major bleeding risk (Harskamp et al., 2019; Noubiap and Kamtchum-Tatuene, 2022). Here, ABCB1 is linked to tuberculosis.