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Xin chào

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

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Xin chào

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  1. Xin chào

  2. Situation of the Thalassemia and Blood Transfusion Services in Lao PDR. Presented by: Dr. DouangChanhKongphaly Dr. KhounthavyPhongsavath

  3. 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/

  4. Health system in Laos • Health services system in Laos is divided into 3 levels: – 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 run by government staffs after working hours. • Non‐communicable diseases national strategy is being developed • No special policy on Hb diseases.

  5. Chlidren’s Hospital in Laos Official Opening Ceremony on 11.11.2011

  6. 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

  7. Official Opening The Thalassemia Clinic Ceremony on 4.05.2012

  8. 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

  9. 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 )

  10. 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

  11. Statistics Accumulated Patients 223 199 173 162

  12. Thalassemia Clinic Statistics at Children’s Hospital • Monthly patients 145 116 110 100 96 85 77 69

  13. Statistics • Monthly transfusions 121 85 88 79 68 62 64 55

  14. Statistics/Project • L-one supported L-one 77 cases 55 cases 44 cases 33 cases 33 cases Project: 1000T/m 12 cases 18 cases

  15. Statistics/Project • Filter supported Filter 30 cases 23 cases 22 cases 21 cases 15 cases 14 cases 14 cases 8cases Project: 10pieces/m

  16. Splenectomy support

  17. we work together between KOICA’s volunteer and staff in Children’s Hospital.

  18. We had educate for Thalassemia family to know about this disease more for 7times/year and more in the future.

  19. Made a poster about take care and treatment Thalassemia. ( Useful Brief Poster)

  20. Thalassemia Handbook Translation supported by the KOICA

  21. 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

  22. Blood Transfusion Services Presented by: Dr. DouangChanhKongphaly National Blood Transfusion Centre

  23. 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)

  24. System of Management 4 3 2 1

  25. 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

  26. 26/21

  27. Blood donor recruitment Based 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

  28. 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.

  29. Percentage of TTI (+) (Year 2011)

  30. 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

  31. Quality management SOPs and Guidelines Trainings Monitoring and Follow up EQAS (External Quality Assurance Scheme) IQC (Internal Quality Control) Data base

  32. 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

  33. 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

  34. Thank you for your attention

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