thalassemia and Hepatitis C
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thalassemia and Hepatitis C

thalassemia and Hepatitis C

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thalassemia and Hepatitis C thalassemia and Hepatitis C Presentation Transcript

  • Thalassaemia and Hepatitis Vinay Shetty Vice President Think Foundation What we can do? 28July-WorldHepatitisDay
  • A facebook page What we can do? 28July-WorldHepatitisDay Name : Xxxxx Yxxxxx Age : 34 years Status : Married Children : 1 son (5 years old) Works at : XYZ Corp. Studied at : Xxxx Inst. Of Mgmt. Interests : Reading and cricket
  • Who is this ? What we can do? 28July-WorldHepatitisDay Xxxxx Yxxxxx is a Thalassaemia Major
  • What did he do right ? What we can do? 28July-WorldHepatitisDay Blood transfusion Pre-transfusion Hb > 9.5 gms/dl Iron chelation Serum Ferritin < 1000 ng/ml Periodic monitoring LFT, RFT, Thyroid, TTIs, Growth, DEXA, MRI
  • What did others do right ? What we can do? 28July-WorldHepatitisDay Transfusion Service Ensured availability of blood Nucleic Acid Amplification Testing Ensured supply of safe blood Health Care system Ensured availability of medicines Provided facilities for monitoring
  • Hepatitis in Thalassaemia patients What we can do? 28July-WorldHepatitisDay Around 10 % of Thalassaemia Major patients infected with Hepatitis C Infection due to transfused blood carrying the virus • Mandatory Hep C testing only after 2002 • Large Window period in current methods Risks higher for Thalassaemia Major due to being multiple-transfused
  • What we can do? 28July-WorldHepatitisDay What should we do ? For general well being Maintain Hb > 9.5 gms/dld Maintain Se Fe < 1000 ng/ml Check all parameters periodically • prepare patient management book and provide to all centres • work with the health department to provide iron chelators • work with sponsors to adopt patients for iron chelation • draw up a centre-wise systematic plan to follow protocol laid down by TIF
  • What should we do ? What we can do? 28July-WorldHepatitisDay Ensure Safety of Blood Collect blood from voluntary donors Employ better testing systems for TTIs For prevention • Organize blood donation camps • Advocacy for implementation of National Blood Policy • Advocacy with Health Ministry/ Drugs Controller/NBTC/Blood Banks for NAAT testing of collected blood
  • What should we do ? What we can do? 28July-WorldHepatitisDay For treatment • Early detection • Determination of type • Resources for treatment • Arrange for Serology tests every 6 months • Select patients for treatment – determine genotype and viral load • Interact with pharma cos. and health authorities for making treatment affordable • Ask health authorities to take responsibility for treatment • Raise resources through sponsors
  • What we can do? 28July-WorldHepatitisDay Grateful to Children’s Liver Foundation All amazing doctors who take care of thalassaemia patients Blood Banks Sponsors
  • What we can do? 28July-WorldHepatitisDay Thank You
  • Blood Banks therefore regulated under Drugs Cosmetics Act, 1940 and rules thereunder. Human Blood covered under the definition of “Drug”. 1940
  • 1989 Notification by Central Govt. under Drugs Cosmetics Rules for mandatory testing for HIV Following Reports of AIDS
  • 1990 Drugs rules amended, and Drugs Controller General of India vested with the power of Central Licence Approving Authority Following Fergusson Report
  • 1992 Public Interest Litigation filed by Mr. H.D. Shourie
  • 1996 Consequent to P.I.L., Supreme Court of India gives directive to the Govt. of India to: • ban commercial/paid donors • formulate comprehensive legislation on blood transfusion services. • form National and State Blood Transfusion Councils
  • 1996 Govt. of India directs Drugs Controller General of India to formulate comprehensive legislation In line with Supreme Court directives
  • 1996 Establishment of Committee headed by Dr. Mukherjee to study possibility of Red Cross running the transfusion service Existing Red Cross network found to be inadequate
  • 1996 Establishment of Committee to formulate National Blood Policy In line with Supreme Court directives
  • 1996 Formation of National Blood Transfusion Council Registered as a Society In line with Supreme Court directives
  • 1996 – 2nd July Formation of Maharashtra State Blood Transfusion Council • Regd. Under Societies Registration Act, 1860 on 22nd Jan., 1997 • Regd. Under Bombay Public Trusts Act, 1950 on 17th April, 1998 In line with Supreme Court directives
  • In line with Supreme Court directives National Blood Policy published by Govt. of India 2002
  • In line with Supreme Court directives Action Plan formulated for National Blood Policy 2003
  • National Blood Policy – Objective 1 To provide safe and adequate quantity of blood, blood components and blood products. The Policy Objective mentions : …..the practice of replacement shall be gradually phased out
  • National Blood Policy – Objective 2 To make available adequate resources to develop and reorganize the blood transfusion service in the country.
  • National Blood Policy – Objective 8 To take adequate legislative and educational steps to eliminate profiteering in blood banks. The Policy Objective mentions : …..as a deterrent to paid blood donors who operate under the guise of replacement donors, institutions who prescribe blood should be made responsible to organize blood for their patients
  • As per National Blood Policy Structure of Transfusion Service N.B.T.C . S.B.T.C./U.T.B.T.C . Red Cross Blood Centre NGO Blood Centre Govt. Blood Centre Satellite Blood Centre R.B.T.C. N.B.T.C. : National Blood Transfusion Council S.B.T.C. : State Blood Transfusion Council U.T.B.T.C. : Union Territory Blood Transfusion Council R.B.T.C. : Regional Blood Transfusion Centre
  • As per National Blood Policy Organizations supporting Transfusion Service NACO – National Aids Control Organization to allocating budget to NBTC DCGI - Drugs Controller General of India To establish and enforce standards for blood and blood products Ministry of Health & Family Welfare To lay guidelines on bio-safety for all Blood Centres
  • As per National Blood Policy Problems - Macro NBTC, being a Council and not an Authority, can only recommend. Legislative action to be taken for implementation of National Blood Policy
  • As per National Blood Policy Problems – on the ground The practice of replacement donor continues Hospitals refuse to take blood from a blood bank, and insist on donors being brought to the Hospital. Too many blood banks, each charging different processing charges
  • The solution One single metropolitan blood bank catering to the city, and maintaining independence from hospitals for blood banking operations Will think of the city’s requirement Uniformity of collection/processing Collection from voluntary donors Will ensure 100% components
  • 100% Voluntary Blood Donation - Mumbai By testing of blood alone can we ensure that blood is safe? Window Period is a serious threat No
  • 100% Voluntary Blood Donation - Mumbai How do we ensure that blood is safe ? By collecting blood from safe donors
  • 100% Voluntary Blood Donation - Mumbai Who is a safe donor? A voluntary donor is safe donor
  • 100% Voluntary Blood Donation - Mumbai Who is a voluntary donor? A person who donates blood without knowing the identity of the recipient