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RRP in Developing Countries

This report by Dr. Arturo Avila Chávez highlights the rising incidence of Recurrent Respiratory Papillomatosis (RRP) in developing countries, ranging from 1500 to 2500 cases nationally. It addresses critical medical, cultural, and economic barriers that lead to late diagnosis and treatment, often only when patients exhibit severe symptoms. There are insufficient specialized care centers and bureaucratic hurdles that delay surgeries and treatment. The report advocates for better education, community support, and improved access to medications, emphasizing the need for systemic reform in health services, training for medical professionals, and patient awareness.

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RRP in Developing Countries

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  1. RRP in Developing Countries Arturo Avila Chávez MD Director Voice Center México

  2. Incidence ??????? • NOT KNOWN • Between 1500 – 2500 cases around the country

  3. Main Problem CULTURAL MEDICAL ECONOMICAL

  4. Voice as an Issue • Voice is NOT a Health Issue • People IGNORE the problem exists • Dysphonia = Alarm • People receive medical care only when they are completely dysphonic or with respiratory distress

  5. Health Services • Public Hospitals (subsidized by government) • ISSSTE • IMSS • SSA • Most of the general population • Not all are free • Different levels of medical attention • 1st – 3d level • Very few centers for high specialized medical attention in all the country

  6. Health Services • 80 to 120 consultations per day • 10 surgeries a day • 6 -8 moth waiting for surgery • Some patients even have to wait to be operated until they have respiratory distress

  7. Health Services • Public Hospitals • Big gap between first consultation and day of surgery • Bureaucratic paper work • Time consuming • Centralized country • Private Practice • The least amount of patients with RRP • Need an Insurance • Otherwise…..Very expensive!

  8. Medical Issues • RRP is a third level attention problem! (Highly Specialized) • Some residency programs don't have a good laryngological training, which reflects a wrong Dx and Tx. • WHY?

  9. Medical Issues • Larynx is ENT´s the most hidden structure

  10. Medical Issues • Equipment • Diagnosis

  11. Medical Issues

  12. Medical Issues

  13. Medical Issues

  14. Medical Issues • Surgery • Equipment

  15. Medical Issues

  16. Medical Issues • Surgical techniques • MICROSURGERY

  17. Antivirals Interferon Vaccines Phytosorb DIM I3C PDT Retinoids Mytomicin Medical Issues

  18. Drugs Availability • Meds • Very expensive $$$ • Interferon • Cidovofir • Non Available • No International Sale Representatives

  19. RRP Information • Pt is not informed about RRP • Cause • Symptoms • Treatment Options • No societies or foundations to support RRP • Patients are all by themselves

  20. Main Problems • Cultural • The RRP manifestations are almost certainly under-described and non existent for general population • Lack of Information (educational programs) • Health care system • Centralized • Better training residency programs • Subspecilized Doctors • DX tools and TX equipment • Drug Availability

  21. Solutions • Take advantage of RRP IRS´s infrastructure as a plataform • Inform People • Most of the affected people only know Spanish and don't have access to internet • Language barrier

  22. Solutions • Expand activities • Create a supportive community network in Developing Countries. • Creat groups of people, committed people, specially patients and Doctors to approach RRP IRS as a backup for multipurpose • Interaction with Meds suppliers for easier access and cheaper prices

  23. Thank You!

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