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Hussain S, Baloch S, Parvin A, Najmuddin A, Musheer F, Junaid M, Memon RN, Bhanbhro F, Ullah H, Moiz B. Inherited Bleeding Disorders-Experience of a Not-for-Profit Organization in Pakistan. Clin Appl Thromb Hemost 2018; 24:1241-1248. [PMID: 29895176 PMCID: PMC6714783 DOI: 10.1177/1076029618781033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Patient registry is a powerful tool for planning health care and setting groundwork for research. This survey reports a detailed registry of inherited bleeding disorders (IBD) and their management at a not-for-profit organization in a developing country to form the basis for planning development and research. We reviewed medical records of patients with IBD from 8 hemophilia treatment centers of Fatimid Foundation located in various cities. Information collected included sociodemographic data, diagnostic tests, severity of hemophilia A and B, number of bleeding episodes per year, site and frequency of hemarthrosis, and seropositivity for viral diseases. We analyzed 1497 patients from November 1, 2015, to April 30, 2016. There were 1296 (87%) males and 201 (13%) females with a mean age of 24.5 (11) years (range, 6 months to 65 years). Hemophilia A constituted the bulk of IBD (848, 57%) followed by von Willebrand disease (172, 11%), hemophilia B (144, 10%), platelet function defect (106, 7%), and rare bleeding disorders (70, 5%). Mucocutaneous bleeding (1144, 76%) and hemarthrosis (1035 patients, 69%) were the main complications. There were 1026 (69%) patients who received only blood components for treatment of any bleeding episode while the remaining 464 (31%) were on combination therapy (blood components and factor concentrate). Seroreactivity for hepatitis C was frequent (28%), while hepatitis B (1%) and human immunodeficiency virus (0.01%) were less commonly seen. This study was an important step toward a patient registry in a hemophilia treatment center in Pakistan. Hemophilia A is the most common bleeding disorder and hepatitis C is the most frequent treatment-related complication.
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Affiliation(s)
| | | | | | - Akbar Najmuddin
- 2 Hemophilia Department, Fatimid Foundation, Karachi, Pakistan
| | | | | | | | | | | | - Bushra Moiz
- 8 Section of Hematology and Transfusion Medicine, Department of Pathology and Microbiology, The Aga Khan University Hospital, Karachi, Pakistan
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Rezende SM, Rodrigues SHL, Brito KNP, da Silva DLQ, Santo ML, Simões BDJ, Genovez G, Melo HT, Araújo JPB, Barca DAAV. Evaluation of a web-based registry of inherited bleeding disorders: a descriptive study of the Brazilian experience with HEMOVIDAweb Coagulopatias. Orphanet J Rare Dis 2017; 12:27. [PMID: 28187737 PMCID: PMC5303203 DOI: 10.1186/s13023-016-0560-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/22/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inherited bleeding disorders (IBD) consist of a group of rare heterogeneous diseases, which require treatment for life. Management of these disorders is complex and costly. Therefore, good quality data of the affected population is crucial to guide policy planning. The aim of this manuscript is to describe the impact of a national, web-based registry - the Hemovidaweb Coagulopatias (HWC) - in the management of the IBD in Brazil. METHODS The system was developed in PHP 5.0 language and is available on the internet at http://coagulopatiasweb.datasus.gov.br . The system was validated in September 2008 and launched nationally with input from January 1, 2009. HWC collects variables related to socio-demographic, clinical, laboratory and treatment data of patients with IBD. RESULTS Within 7 years, there was an increment of 90.8% on the diagnosis of IBD altogether, which increased from 11,040 in December 2007 to 21,066 in December 2014. This is now the fourth and third largest world population of patients with haemophilia and von Willebrand's disease (vWD), respectively, according to the most recent (2015) Annual Global Survey of the World Federation of Hemophilia. The data collected provided the basis for planning and implementing home therapy, prophylaxis and immune tolerance induction (ITI), recently initiated in Brazil. CONCLUSION HWC was an effective tool in the increment of registration of patients with IBD in Brazil. Furthermore, it was essential to support policy planning, monitoring, evaluation and treatment. Future development should focus on surveillance, health outcomes and research. Every country should implement a national registry on IBD.
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Affiliation(s)
- Suely Meireles Rezende
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 190 - 2nd floor- room 243, Belo Horizonte, Minas Gerais, ZIP 30130-110, Brazil. .,Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil.
| | - Silvia Helena Lacerda Rodrigues
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
| | - Kelly Neves Pinheiro Brito
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
| | - Diego Lima Quintino da Silva
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
| | - Marcos Lázaro Santo
- Departamento de Informática do Sistema Único de Saúde (DATASUS), Rua México - Centro, Rio de Janeiro, ZIP 20031-143, Brazil
| | - Bárbara de Jesus Simões
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
| | - Guilherme Genovez
- Hemocentro de Santa Catarina, Av. Othon Gama D'Eça, 756 Centro, Florianópolis, Santa Catarina, ZIP 88015-240, Brazil
| | - Helder Teixeira Melo
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
| | - João Paulo Baccara Araújo
- Coordenação Geral de Sangue e Hemoderivados, Ministry of Health, SAF Sul, Edifício Premium, Torre II, room 202, CEP:70070-600, Brasília, Distrito Federal, Brazil
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Chemaitelly H, Chaabna K, Abu-Raddad LJ. The Epidemiology of Hepatitis C Virus in the Fertile Crescent: Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0135281. [PMID: 26296200 PMCID: PMC4546629 DOI: 10.1371/journal.pone.0135281] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 07/20/2015] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To characterize hepatitis C virus (HCV) epidemiology in countries of the Fertile Crescent region of the Middle East and North Africa (MENA), namely Iraq, Jordan, Lebanon, Palestine, and Syria. METHODS We systematically reviewed and synthesized available records of HCV incidence and prevalence following PRISMA guidelines. Meta-analyses were implemented using a DerSimonian-Laird random effects model with inverse weighting to estimate the country-specific HCV prevalence among the various at risk population groups. RESULTS We identified eight HCV incidence and 240 HCV prevalence measures in the Fertile Crescent. HCV sero-conversion risk among hemodialysis patients was 9.2% in Jordan and 40.3% in Iraq, and ranged between 0% and 3.5% among other populations in Iraq over different follow-up times. Our meta-analyses estimated HCV prevalence among the general population at 0.2% in Iraq (range: 0-7.2%; 95% CI: 0.1-0.3%), 0.3% in Jordan (range: 0-2.0%; 95% CI: 0.1-0.5%), 0.2% in Lebanon (range: 0-3.4%; 95% CI: 0.1-0.3%), 0.2% in Palestine (range: 0-9.0%; 95% CI: 0.2-0.3%), and 0.4% in Syria (range: 0.3-0.9%; 95% CI: 0.4-0.5%). Among populations at high risk, HCV prevalence was estimated at 19.5% in Iraq (range: 0-67.3%; 95% CI: 14.9-24.5%), 37.0% in Jordan (range: 21-59.5%; 95% CI: 29.3-45.0%), 14.5% in Lebanon (range: 0-52.8%; 95% CI: 5.6-26.5%), and 47.4% in Syria (range: 21.0-75.0%; 95% CI: 32.5-62.5%). Genotypes 4 and 1 appear to be the dominant circulating strains. CONCLUSIONS HCV prevalence in the population at large appears to be below 1%, lower than that in other MENA sub-regions, and tending towards the lower end of the global range. However, there is evidence for ongoing HCV transmission within medical facilities and among people who inject drugs (PWID). Migration dynamics appear to have played a role in determining the circulating genotypes. HCV prevention efforts should be targeted, and focus on infection control in clinical settings and harm reduction among PWID.
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Affiliation(s)
- Hiam Chemaitelly
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
| | - Karima Chaabna
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College in Qatar, Cornell University, Qatar Foundation, Education City, Doha, Qatar
- Department of Healthcare Policy & Research, Weill Cornell Medical College, Cornell University, New York, New York, United States of America
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