Thalassemia in Laos:   Thalassemia in Laos:   Situation analysis                 y           Dr. Sourideth Sengchanh      ...
Country profile                      Country profile• P  Population of 5,621,000        l ti     f 5 621 000• Laos is also...
Health system in Laos          Health system in Laos• Health services system in Laos is divided into 3   levels:  – Primar...
Data in 3 central hospitals (2009‐2010)Data in 3 central hospitals (2009 2010)•   51 cases of beta‐thalassemia major•   22...
Diagnostic services available        g• Screening tests          g  – Mean Corpuscular Hemoglobin (MCH)  – Mean Corpuscula...
Unavailability of diagnostic test  Unavailability of diagnostic test• HPLC• Polymerase Chain Reaction  Polymerase Chain Re...
Utilization of Blood components  Utilization of Blood components• Blood donation center is under Lao red cross• Blood dona...
Barriers of thalassemia control in LaosBarriers of thalassemia control in Laos  – Policy of thalassemia control is not ava...
The way forwards            The way forwards• Development of national strategic planning for                              ...
The way forwards                  y• Inclusion of iron chelators into national  Inclusion of iron chelators into national ...
Thank You for Your AttentionThank You for Your Attention
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Republic of Laos - Current Situation in Control Strategies and Health Systems in Asia

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Thalassemia in Laos: Situation Analysis by Dr. Sourideth Sengchanh, Dr. Alongkone Phengsavanh, Assoc. Prof. Dr. Khampe Phongsavat, University of Health Sciences, Vientiane, Laos. Presented by Assoc. Prof. Dr. Khampe Phongsavat.

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Republic of Laos - Current Situation in Control Strategies and Health Systems in Asia

  1. 1. Thalassemia in Laos:  Thalassemia in Laos: Situation analysis y Dr. Sourideth Sengchanh id h h h Dr. Alongkone Phengsavanh Assoc. Prof. Dr. Khampe Phongsavat p gUniversity of Health Sciences, Vientiane , Laos
  2. 2. Country profile Country profile• P Population of 5,621,000  l ti f 5 621 000• Laos is also very ethnically  diverse, and socio‐cultural beliefs  , and practices among the 49  ethnic groups.• Laos is having geographic and Laos is having geographic and  financial barriers and relatively  poor health infrastructure.• Laos has experienced relatively  high economic growth in the last  decade• Total budget on health is less  than 10%• Annual birth rate Annual birth rate• Average income
  3. 3. Health system in Laos Health system in Laos• Health services system in Laos is divided into 3  levels: – Primary care : Health centers and district hospitals y p – Secondary care: Provincial and regional hospitals – Tertiary care: Central and University hospitals Tertiary care: Central and University hospitals• No private hospital, only private clinic are run  by government staffs after working hours. by government staffs after working hours• Non‐communicable diseases national strategy  is being developed i b i d l d• No special policy on Hb diseases. p p y
  4. 4. Data in 3 central hospitals (2009‐2010)Data in 3 central hospitals (2009 2010)• 51 cases of beta‐thalassemia major• 224 cases of Beta thal/B Hb E disease 224 cases of Beta‐thal/B Hb E disease• 78 cases of Hb E trait (hospital data base)• 29 cases of Alpha thalassemia• 37 cases of splenectomy 37 cases of splenectomy• 177 cases of iron overload• 82 cases of iron chelation• Prevalence of Hydrops Fetalis: 0.3% Prevalence of Hydrops Fetalis: 0 3%
  5. 5. Diagnostic services available g• Screening tests g – Mean Corpuscular Hemoglobin (MCH) – Mean Corpuscular Volume (MCV) Mean Corpuscular Volume (MCV) – Osmotic Fragility test (OFT) • Confirmed test – Hemoglobin typing
  6. 6. Unavailability of diagnostic test Unavailability of diagnostic test• HPLC• Polymerase Chain Reaction Polymerase Chain Reaction• Prenatal diagnostic  – Amniocentesis – Cordocentesis
  7. 7. Utilization of Blood components Utilization of Blood components• Blood donation center is under Lao red cross• Blood donation is inadequate Blood donation is inadequate• Almost blood components can be separated  such as h – Whole blood – Pack red cells – Cryoprecipitate – Platelet – Fresh Frozen Plasma
  8. 8. Barriers of thalassemia control in LaosBarriers of thalassemia control in Laos – Policy of thalassemia control is not available – National guideline for thalassemia screening and  treatment is not unified – Lacking of human resources such as hematologist Lacking of human resources  such as hematologist  , laboratory technicians, etc – Lacking of medical equipment in the field of Lacking of medical equipment in the field of  hematology – Iron chelators are not included in the essential Iron chelators are not included in the essential  drug list – Thalassemia treatment unit is not available
  9. 9. The way forwards The way forwards• Development of national strategic planning for  p thalassemia treatment and prevention• Development of update national treatment  guidelines for thalassemia guidelines for thalassemia• Initiation of national thalassemia screening  program• Development of community and hospital Development of community and hospital  based registration system for thalassemia.
  10. 10. The way forwards y• Inclusion of iron chelators into national Inclusion of iron chelators into national  essential drug list• I Increasing the public  awareness and  i th bli d community motivation regarding the cost  effectiveness for thalassemia prevention and  treatment• Organize the thalassemia prevention campaign• Collaborate internationally in term of research 
  11. 11. Thank You for Your AttentionThank You for Your Attention

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