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
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Alok SrivastavaM.D.
Department of Haematology, Christian Medical College, Vellore-632004, India
Email: aloks@cmcvellore.ac.in
