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Xin chào. Situation of the Thalassemia and Blood Transfusion Services in Lao PDR. Presented by: Dr. DouangChanh Kongphaly Dr. Khounthavy Phongsavath.

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Presentation on theme: "Xin chào. Situation of the Thalassemia and Blood Transfusion Services in Lao PDR. Presented by: Dr. DouangChanh Kongphaly Dr. Khounthavy Phongsavath."— Presentation transcript:

1 Xin chào

2 Situation of the Thalassemia and Blood Transfusion Services in Lao PDR. Presented by: Dr. DouangChanh Kongphaly Dr. Khounthavy Phongsavath

3 Country profile Population of Laos is also very ethnically diverse, and sociocultural 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:

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 Chlidrens Hospital in Laos Official Opening Ceremony on

6 Background 2009 – Start managing Thalassaemia patients in Mother and Child Hospital Jan; KOICA launches Thalassaemia project in MCH Nov; The Childrens Hospital opens -Dec; 1 st Staff meeting for preparing Thalassaemia clinic Feb; Thalassaemia conference in Bangkok -Mar; Blood Strorage unit established in Childrens hospital - May ; Thalassaemia Clinic opens supported by KOICA, HHA - July; Start importing L-one (deferiprone) in Childrens Hospital

7 Official Opening The Thalassemia Clinic Ceremony on

8 Activity Publishing Books – Dec, 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 Childrens 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 ( Setthatilaths Hospital )

10 The Hematology Data in Childrens 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

12 Thalassemia Clinic Statistics at Childrens Hospital Monthly patients

13 Statistics Monthly transfusions

14 Statistics/Project L-one supported L-one 12 cases18 cases 33 cases Project: 1000T/m 33 cases 44 cases 77 cases 55 cases

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

16 Splenectomy support

17 we work together between KOICAs volunteer and staff in Childrens 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 Patients Association (Not organized yet) Keep on good relationship with the Blood Bank Participate blood donation activities

22 Blood Transfusion Services Presented by: Dr. DouangChanh Kongphaly 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 : 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 10 Storage Units in District & Military Hospitals 13 Blood Banks in Provincial Hospital 3 Provincial Blood Centre NBTC Govt. provides upgrading NBTC provides equipment for set up and training for staff in group X-matching, cold chain management and transfusion PBC or BB in PH provides blood (2O, 2B, 1A) PH provides space and staff for the collection, processing, testing, storage and distribution of blood LRC provincial branch provides staff for donor recruitment NBTC provides equipment, reagents, training, supervision and management of blood program Managed by LRC Full function of blood program Managed by LRC Responsibility for whole country Provide full function of blood program Provide management, training and resource support to provincial blood centers, provincial hospital blood banks and district hospital storage unit

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

29 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.

30 Percentage of TTI (+) (Year 2011)

31 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

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

33 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

34 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

35 35 Thank you for your attention


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