xin chào. situation of the thalassemia and blood transfusion services in lao pdr. presented by: dr....
TRANSCRIPT
Xin chào
Situation of the Thalassemia and Blood Transfusion Services
in Lao PDR.
Presented by: Dr. DouangChanh Kongphaly Dr. Khounthavy Phongsavath
Country profile• Population of 6.0256.197• Laos is also very ethnically diverse,
and socio cultural beliefs‐ and practices among the 49 ethnic groups.• Laos is having geographic and financial barriers and relatively poor health infrastructure.• Laos has experienced relatively high economic growth in the last decade.
Source: www.who.int/countries/lao/en/
Health system in Laos
• Health services system in Laos is divided into 3levels:– Primary care : Health centers and district hospitals– Secondary care: Provincial and regional hospitals– Tertiary care: Central and University hospitals• No private hospital, only private clinic are runby government staffs after working hours.• Non‐communicable diseases national strategyis being developed• No special policy on Hb diseases.
Chlidren’s Hospital in Laos Official Opening Ceremony on 11.11.2011
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Background• 2009 – Start managing Thalassaemia patients in Mother and Child
Hospital• 2010
-Jan; KOICA launches Thalassaemia project in MCH• 2011
-Nov; The Children’s Hospital opens-Dec; 1st Staff meeting for preparing Thalassaemia clinic
• 2012 - Feb; Thalassaemia conference in Bangkok- Mar; Blood Strorage unit established in Children’s
hospital- May ; Thalassaemia Clinic opens supported by KOICA, HHA - July; Start importing L-one (deferiprone) in Children’s
Hospital
Official Opening The Thalassemia Clinic Ceremony on 4.05.2012
Activity• Publishing Books
– Dec, 2010-Translating TIF book “About Thalassaemia” in Lao language.-Translating Patient follow up book in Lao language.
• Patient support– Jan, 2010 ~ Support transfusion, filter, iron chelation available
( Provide only at Children’s hospital ).Support splenectomy (20 cases for poor patients )
• Patient education– Sep 2011 ~ July 2012 Total 8 times of patient meetings and lectures
Diagnostic services available:
• CBC• Morphology• Ferritin Serum• Hemoglobin
Electrophoresis
Unavailability of diagnostic test
• Polymerase Chain Reaction
• Serum Iron/Transferrin/TIBC ( referred Example to Thailand ).
• Bone Marrow Analysis ( Setthatilath’s Hospital )
The Hematology Data in Children’s Hospital
Thalassemia patients 229 cases:TDT/NTDT (111/118)
• 98 cases of Thalassemia HbE disease • 04 cases of Beta Thalassemia Major• 61 cases of Thalassemia E/B• 58 cases of Thalassemia HbH disease• 50 cases of Iron Overload • 20 cases of Spleenectomy
ITP 03 cases IDA 04 cases
Statistics
Accumulated Patients
162
173
223
199
Thalassemia Clinic Statistics at Children’s Hospital
• Monthly patients
0
50
100
150
200
Nov Dec Jan Feb Mar Apr May Jun
Patient …
6977
8596
110100
145
116
Statistics
• Monthly transfusions
5562 68 64
7985 88
121
Statistics/Project
• L-one supported L-one
12 cases 18 cases
33 cases
Project: 1000T/m
33 cases44 cases
77 cases
55 cases
Statistics/Project
• Filter supported Filter
14 cases
30 cases
21 cases23 cases
Project: 10pieces/m
22 cases
14 cases15 cases
8cases
Splenectomy support
we work together between KOICA’s volunteer and staff in Children’s Hospital.
We had educate for Thalassemia family to know about this disease more for 7times/year and more in the future.
Made a poster about take care and treatment Thalassemia. ( Useful Brief Poster)
Thalassemia Handbook Translation supported by the KOICA
Future Task• Enhance the ability of Laboratory • Development of national strategic planning for
thalassemia treatment and prevention.• Development of update national treatment guidelines for
thalassemia.• Initiation of national thalassemia screening program.• Import Desferal to the hospital• Find more support from Foreign Organizations (WHO
etc…)• Make National Guideline, National Registration• Make deep relationship with the National Patient’s
Association (Not organized yet)• Keep on good relationship with the Blood Bank• Participate blood donation activities
Blood Transfusion Services
Presented by: Dr. DouangChanh KongphalyNational Blood Transfusion Centre
Background• 1975 Blood service started in Vientiane Capital and
played a leading roles in providing adequate and safe blood supply.
• 1991, MOH transferred this responsibility to the Lao Red Cross.
• 1995 -2003: blood services were structured with:- Official national blood program- National Blood Policy ( Decree 84/PM, 30/12/1995)- National Blood Transfusion Committee ( Decree 01/PM,05/01/1998)
System of Management
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Main Activities
• Blood donor recruitment• Blood collection• Blood testing:
- Immuno-haematology - Transfusion Transmitted Infectious
• Blood storage and distributions• Quality management• Training: Lab tech, Blood Centre staff, medical
staff
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Blood donor recruitmentBased on non-remunerated blood donation.How to make a campaign?
- Public relations: oral talk, posters, pamph songs,banners, invitation; or through mass media(radio/TV,Newsp,magazine..)
- Organize special event in the main days- Organize blood donation campaign
planning meeting with partner sectors- Training donor recruiters: Youth donor club: universities, colleges, high schools, army, police
0
5000
10000
15000
20000
25000
30000
Blo
od
un
its
Year
Blood collection
Blood Testing
• All collected blood unit had been systematically testing for:- Blood Grouping,- Antibody screening- Cross-matching - Identification Antibody- Screening for TTI ( HIV, HBV, HCV and Syphilis )
before transfusion to the patients.
Percentage of TTI (+) (Year 2011)
Blood Storage and supply• Whole blood (WB) 80 %• Blood components: 20%
- Concentrate Red Cells (CRC)- Fresh Frozen Plasma (FFP)- Platelet Concentrate (PC)- Platelet Rich Plasma (PRP)
• Promotion of clinical appropriate use of blood/blood components
Quality management
• SOPs and Guidelines• Trainings • Monitoring and Follow up• EQAS (External Quality Assurance Scheme)• IQC (Internal Quality Control)• Data base
Difficulties/Challenges
• Increasing demand of blood supply• Percentage of VNRD VS Number of Collection• Awareness people on blood donation still
limited• High percentage of infected blood unit• Self sufficient sustainability• HR• Infrastructure
Future Direction• Increase Number of Blood Collection
through blood donation promotions • Follow up the Strategic Plan• Extend blood transfusion services to district
level• Human Resource Development• Improve Quality Management System• Strengthen the capacity of Provincial
networks
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Thank you for your attention