Semin Thromb Hemost 2005; 31: 495-500 DOI: 10.1055/s-2005-922219
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Hemophilia Treatment in Developing Countries: Products and Protocols
Alok Srivastava1, Steve K. You2, Yasmin Ayob3, Ampaiwan Chuansumrit4, Norma de Bosch5, Raul Perez Bianco6, Fereydoun Ala7
1 Professor, Christian Medical College, Vellore, India 2 Korean Hemophilia Foundation, Seoul, Korea 3 National Blood Centre, Kuala Lumpur, Malaysia 4 Ramathibodi Hospital, Bangkok, Thailand 5 Centro Nacional de Hemofilia, Caracas, Venezuela 6 Hematological Research Institute, Buenos Aires, Argentina 7 Iranian Hemophilia Society, Teheran, Iran

ABSTRACT

The most important aspect of management of hemophilia is to provide adequate replacement of safe clotting factor concentrates to prevent or treat bleeding episodes. There has been considerable progress in many countries in the developing world with regard to this aspect of care. However, very little data are available in the literature on the types of products being used for factor replacement and the doses being administered for control or treatment of bleeding in different countries. These data are important to document because only then can data from different centers be compared. This article provides data from seven countries: Korea, Malaysia, Thailand, Venezuela, Argentina, Iran, and India. It shows that there is wide variability not only in the types of products used (plasma to recombinant factor concentrates) but also in the doses administered (minimal to very high) for similar indications. Prospective documentation of data on musculoskeletal outcome at these centers and correlation with dose of factor replacement could help identify different models of care. Comparing such data and collating the experience in different countries could be useful for optimizing care and establishing cost-effective models. The combined experience in the developing world in providing hemophilia services should be used to define standards of care that are practical and to set achievable goals.

KEYWORDS

Hemophilia - treatment - developing countries