Publication: Management of haemophilia in the developing world
Issued Date
1998-08-10
Resource Type
ISSN
13518216
Other identifier(s)
2-s2.0-0031876990
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Haemophilia. Vol.4, No.4 (1998), 474-480
Suggested Citation
A. Srivastava, A. Chuansumrit, M. Chandy, G. Duraiswamy, C. Karagus Management of haemophilia in the developing world. Haemophilia. Vol.4, No.4 (1998), 474-480. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/18500
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Thesis
Title
Management of haemophilia in the developing world
Abstract
The problems with management of haemophilia in developing countries are poor awareness, inadequate diagnostic facilities and scarce factor concentrates for therapy. The priorities in establishing services for haemophilia include training care providers, setting up care centres, initiating a registry, educating affected people and their families about the condition, providing low-cost factor concentrates, improving social awareness and developing a comprehensive care team. A coagulation laboratory capable of reliably performing clotting times with correction studies using normal pooled, FVIII and FIX deficient patient plasma and factor assay is most essential for diagnosis. More advanced centralized laboratories are also needed. Molecular biology techniques for mutation detection and gene tracking should be established in each country for accurate carrier detection and antenatal diagnosis. Different models of haemophilia care exist. In India, there is no support from the government. Services, including import of factor concentrates, are organized by the Haemophilia Federation of India, with support from other institutions. Haemophilia is managed with minimal replacement therapy (about 2000 i.u./PWH/year). In Malaysia, where the system is fully supported by the government, facilities are available at all public hospitals and moderate levels of factor concentrates are available 'on-demand' (about 11,000 i.u./PWH/year) at the hospitals. Haemophilia care in South Africa is provided through major public hospitals. Intermediate purity factor concentrates are locally produced labour 12,000 i.u./PWH/year) at low cost. The combined experience in the developing world in providing haemophilia services should be used to define standards for care and set achievable goals.