Cambodia - Current Situation in Control Strategies and Health Systems in Asia

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CURRENT SITUATION IN CONTROL STRATEGIES & HEALTH SYSTEMS IN ASIA - CAMBODIA by PRAK PISETH RAINGSEY, MD, DND, MPH Director Preventive Medicine Department MINISTRY OF HEALTH

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Cambodia - Current Situation in Control Strategies and Health Systems in Asia

  1. 1. CURRENT SITUATION IN CONTROL STRATEGIES & HEALTH SYSTEMS IN ASIA- CAMBODIA1st Pan-Asian on Haemoglobinopathies Bangkok, 8-10 February 2012Royal Orchid Sheraton Hotel & Towers PRAK PISETH RAINGSEY MD, DND, MPH Director Preventive Medicine Department i di i MINISTRY OF HEALTH
  2. 2. DEMOGRAPHIC-Area 181,040 sq. km-Population 13,395,682-Ethnic groups: Khmer 90% h Vietnam 5% Chinese 1% Ethnic 2.8% Eth i 2 8% Other 1.2%-Annual Birth Rate 1.54%-Capita G C GDP USD 783 (2010) S 83-Total National Budget on Health $106.49Million $106 49Million-RGC spends 6% of GDP on health (2009) ( )
  3. 3. HEALTH SYSTEMPublic sector -3 level of care National Hospital 8 Referral Hospital 79 Health Center 984 and Health Post 111Private sector H Hospital/ Polyclinic/Cabinet 3 755 it l/ P l li i /C bi t 3,755 No Health insurance from the government NCDs and other public health problem were the 3rd p p priority of Health strategic plan NCDs policy and strategy focused only on CVDs, Cancer, diabetes and NCDs risk factors ( PA, diet, Tobacco and alcohol) T b d l h l) No special policy on Hb disorders / but only policy for Safe Blood Transfusion
  4. 4. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEY Anemia is a chronic problem in Cambodia, 60% of children are anemic with Hb < 105 g/L and 40% related to iron deficiency. Retrospective study used to gather all information on hemoglobinopathy among children under aged of 19 years. Nine provinces were randomized for performed studies to identify the Prevalence Rates of Hemoglobinopathies in Cambodia during the past 10 years ( 2000-2010)Robyn Devenish January, 2010
  5. 5. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEY Based on studies performed during the past 10 years (2000-2010)Robyn Devenish January, 2010
  6. 6. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEY Based on studies performed during the past 10 years (2000-2010)Robyn Devenish January, 2010
  7. 7. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEYRESULT Several different methods were used by the various studies for Hb typing and Hb Genotyping Two of the studies were specifically aimed at the prevalence of hemoglobinopathies FFour of the nine studies, tested for both α and β f th i t di t t d f b th d thalassaemia. Among 4 111 children only 53.34% have been tested 4,111 53 34% on β-α thalassaemia and the other did not tested α thalassaemiaRobyn Devenish January, 2010
  8. 8. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEYRESULT 41% of children had hemoglobinopathie Hb H diseases 0.04% Hb E homogeneous 17% Hb E heterogeneous 29% Hb E trait 20 % Hb E/ β thalassaemia 13% β thalassaemia 0.01% α thalassaemia 20.95%.Robyn Devenish January, 2010
  9. 9. PREVALENCE RATE OF HEMOGLOBINOPATIES SURVEY No national policy or program on the prevention and control of thalassaemia Limited laboratory capacity to deal with thediagnosis of Hemoglobinopathies Few pediatric hospital were able to do for Brilliant cresyl blue stain for Hb H bodies, Hb electrophoresis bodies and DCIP (Dicholophenolindol) screening test for Hb E. many cases go undiagnosed and untreated or misdiagnosed The red blood cell transfusion is the only treatment available The urgent need to reduce the overall number of affected births and to improve the survival and quality of life of the patients with Hb disorders in Cambodia Cambodia.Robyn Devenish January, 2010
  10. 10. THALASSEAMIA TREATMENT  Packed Red cells (PRC) is the only treatment available but low availability  Leukocyte Poor-Red cells (LPRC) is currently not available  Splenectomy available in some hospitals  Iron Chelatoris not availableDr Chean Sophâl.Mékong Santé , 2010
  11. 11. THALASSEAMIA TREATMENTDr Chean Sophâl.Mékong Santé , 2010
  12. 12. NATIONAL PREVENTION PROGRAM R R R Thalassaemia prevention is one of action in NCDs policy & strategic plan of the MoH Guidelines for the clinical Management of Patients with Thalassaemia ( 2011) Th l i Training health professional at all level on the Thalassaemia Management Only CBC result and morphology at : - The National Institute of Public Health Brilliant cresyl blue stain for Hb H bodies done from the beginning of 20062006. - The Pasteur Institute in Phnom Penh Hb electrophoresis - Th A k The Angkor H Hospital for Children in Si it l f Child i Siem RReap DCIP (Dicholophenolindol) screening test for Hb E Brilliant cresyl blue stain for Hb H bodies
  13. 13. NEXT STEP Policy development on Thalasseamia Establish Molecular diagnostic center National Survey to find out a prevalence of Thalasseamia Awareness raising on Thalasseamia g screening and prevention Develop IEC material

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