สถาบันวิจัยวิทยาศาสตร์สาธารณสุข

National Institute of Health of Thailand

Prevention of Thalassemia: Experiences from Samui Island

Authors : Somchai Sangkitporn*, Narumol Chongkitivitya**, Sermsri Pathompanichratana*** ,Siripakorn K Sangkitporn*,Boonnipa Songkharm**, Urai Watanapocha ** ,Wantanee Pathtong***

Affiliation :                 *National Institute of Health, Department of Medical Sciences, Nonthaburi, 11000

                                 **Regional Medical Sciences Center in Suratthani, Suratthani, 84100

          ***Samui Hospital, Suratthani, 84140, Thailand
 
Source:        Journal of the Medical Association of Thailand 2004; 87: 204-212
 
Language:    English
 
Abstract:
 
Thalassemia is one of the most important genetic disorders in Thailand.    A model for prevention of thalassemia by combining 4 strategies including education, carrier screening, counseling and prenatal diagnosis was developed by a thalassemia task force. Thalassemia working group was formed in order to develop a mechanism to integrate the model for real use on Samui Island where thalassemia is common and a specific disease oriented program is required. 200 health professionals working on Samui Island were participated in the thalassemia educational courses. The specific training courses were also provided for obstraticians, medical technologists and counselors. A team of well-trained health professionals was established to manage public education. Information booklets, posters, brochures and mass media including spot radio and newspapers were used as educational materials. For carrier screening, blood samples of pregnant women from all health care organizations on Samui Island were collected and screened for thalassemia carriers by using OF/DCIP tests at Samui Hospital. Samples with positive results were sent to Regional Medical Sciences Center in Suratthani for thalassemia diagnosis. When a carrier was identified, her spouse was offered testing. For at-risk couples, details of the disorder were included in counseling to help them reach a decision that was right to them, in the context of their unique medical, moral and social situations. Amniotic fluid samples were collected for prenatal diagnosis. All patient information was registered by using computer software. After 1 year of integration by using facilities of the Ministry of Public Health service system, a wide range of problems were identified. They underlined the need for effective health service structureco-operation, adequate education of responsible health professionals, explicit policies and a clear line of responsibility at local, regional and national levels for service development and quality management. It is hoped that all information conducted in this study could be useful for health authorities to develop an explicit policy and promote the health service structure co-operation in the country that finally leads to remarkably successful in reducing the frequencies of severe thalassemia in the future.