Prevention of Thalassemia : Experiences from Samui Island
SOMCHAI SANGKITPORN, MD*, NARUMOL CHONGKITIVITY A, BSc**,
SERMSRI PATHOMPANICHRATANA, MD***, SIRIPAKORN K SANGKITPORN, MSc*,
BOONNIPA SONGKHARM, BSc**, URAl W AT ANAPOCHA, BNS***,
WANTANEE PATHTONG, BSc***
Affiliation : * Nationallnstitute of Health, Department of Medical Sciences, Nonthaburi 11000,
**Regional Medical Sciences Center in Surat Thani, Sural Thani 84100,
*** Samui Hospital, Sural Thani 84140, Thailand.
AbstractThalassemia is one of the most important genetic disorders in Thailand. A model for preven
tion of thalassemia by combining 4 strategies including education, carrier screening, counseling and
prenatal diagnosis was developed by a thalassemia task force. A thalassemia work 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 participated in the thalassemia educational courses. The specific training courses were
also provided for obstreticians, 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 the osmotic fragility (OF) test/the dichloro
phenol indophenol precipitation (DCIP) tests at Samui Hospital. Samples with positive results were
sent to the Regional Medical Sciences Center in Surat Thani 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 medi
cal, 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 structure co-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 the present study will be useful to health authorities to develop an explicit policy and
promote the health service structure co-operation in the country that will finally lead to successfully
reducing the frequency of severe thalassemia in the future.
Keywords : Thalassemia, Prevention, Thailand
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