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Thalassemia in Laos:
Thalassemia in Laos:
Situation analysis
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Dr. Sourideth Sengchanh
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Dr. Alongkone Phengsavanh
Assoc. Prof. Dr. Khampe Phongsavat
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University of Health Sciences, Vientiane , Laos

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Country profile
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Population of 5,621,000
l ti f 5 621 000
• Laos is also very ethnically
diverse, and socio‐cultural beliefs
,
and practices among the 49
ethnic groups.
• Laos is having geographic and
Laos is having geographic and
financial barriers and relatively
poor health infrastructure.
• Laos has experienced relatively
high economic growth in the last
decade
• Total budget on health is less
than 10%
• Annual birth rate
Annual birth rate
• Average income

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Health system in Laos
• Health services system in Laos is divided into 3
levels:
– Primary care : Health centers and district hospitals
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– Secondary care: Provincial and regional hospitals
– Tertiary care: Central and University hospitals
Tertiary care: Central and University hospitals
• No private hospital, only private clinic are run
by government staffs after working hours.
by government staffs after working hours
• Non‐communicable diseases national strategy
is being developed
i b i d l d
• No special policy on Hb diseases.
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Data in 3 central hospitals (2009‐2010)
Data in 3 central hospitals (2009 2010)
• 51 cases of beta‐thalassemia major
• 224 cases of Beta thal/B Hb E disease
224 cases of Beta‐thal/B Hb E disease
• 78 cases of Hb E trait (hospital data base)
• 29 cases of Alpha thalassemia
• 37 cases of splenectomy
37 cases of splenectomy
• 177 cases of iron overload
• 82 cases of iron chelation
• Prevalence of Hydrops Fetalis: 0.3%
Prevalence of Hydrops Fetalis: 0 3%

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• Screening tests
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– Mean Corpuscular Hemoglobin (MCH)
– Mean Corpuscular Volume (MCV)
Mean Corpuscular Volume (MCV)
– Osmotic Fragility test (OFT)

• Confirmed test
– Hemoglobin typing

Unavailability of diagnostic test
Unavailability of diagnostic test
• HPLC
• Polymerase Chain Reaction
Polymerase Chain Reaction
• Prenatal diagnostic
– Amniocentesis
– Cordocentesis

Utilization of Blood components
Utilization of Blood components
• Blood donation center is under Lao red cross
• Blood donation is inadequate
Blood donation is inadequate
• Almost blood components can be separated
such as
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– Whole blood
– Pack red cells
– Cryoprecipitate
– Platelet
– Fresh Frozen Plasma

Barriers of thalassemia control in Laos
Barriers of thalassemia control in Laos
– Policy of thalassemia control is not available
– National guideline for thalassemia screening and
treatment is not unified
– Lacking of human resources such as hematologist
Lacking of human resources such as hematologist
, laboratory technicians, etc
– Lacking of medical equipment in the field of
Lacking of medical equipment in the field of
hematology
– Iron chelators are not included in the essential
Iron chelators are not included in the essential
drug list
– Thalassemia treatment unit is not available

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The way forwards
• Development of national strategic planning for
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thalassemia treatment and prevention
• Development of update national treatment
guidelines for thalassemia
guidelines for thalassemia
• Initiation of national thalassemia screening
program
• Development of community and hospital
Development of community and hospital
based registration system for thalassemia.

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• Inclusion of iron chelators into national
Inclusion of iron chelators into national
essential drug list
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Increasing the public awareness and
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community motivation regarding the cost
effectiveness for thalassemia prevention and
treatment
• Organize the thalassemia prevention campaign
• Collaborate internationally in term of research

Thank You for Your Attention
Thank You for Your Attention

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