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Xin chào.

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Presentation on theme: "Xin chào."— Presentation transcript:

1 Xin chào

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

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:

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

6 Background -Jan; KOICA launches Thalassaemia project in MCH
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 Patient support Patient education 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 Project: 1000T/m 77 cases

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

16 Splenectomy support Case No Sex/Age OP date #1 Male/9 14/Mar/2012 #2
Female/8 24/May/2012 #3 Male/11 21/June/2012

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
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. DouangChanh Kongphaly National Blood Transfusion Centre

23 Background 1995 -2003: blood services were structured with:
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 4 3 2 1 Govt. provides upgrading
10 Storage Units in District & Military Hospitals 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) 13 Blood Banks in Provincial Hospital 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 3 Provincial Blood Centre Managed by LRC Full function of blood program NBTC 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 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 Notes WHO recommends an integrated strategy for safe blood transfusion and for minimizing the risks associated with transfusion. The strategy includes: collection of blood from safe, voluntary unpaid blood donors testing of donated blood for transfusion-transmissible infections and blood groups in quality-assured manner, and correct storage and transportation of blood safe and rational use of blood for improving clinical transfusion practices establishment of nationally-coordinated blood transfusion services with quality systems in all areas system for monitoring, reporting and investigation of adverse events associated with transfusion 26/21 26

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) % Blood components: % - 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 Thank you for your attention


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