Background: Thalassaemia affects many families in Northeast Syria, an area devastated by over a decade of conflict which has significantly impacted their health system. People with thalassaemia require holistic multidisciplinary care for the clinical complications of thalassaemia. The risks of thalassaemia treatment include blood-borne viral infections secondary to unsafe transfusion, increased vulnerability to serious bacterial infection following splenectomy, and complications of both iron overload and iron chelation therapy. Médecins Sans Frontières (MSF) provided outpatient thalassaemia care programmes in northeast Syria between April 2017 October 2019 in a complex conflict context challenged by population displacement, the destruction of medical facilities, and periods of insecurity.

Methods: We performed a secondary descriptive analysis of the thalassaemia cohort data to describe basic clinical and demographic characteristics of the patient population. A desk review of internal and publicly available documents was supplemented by informal interviews with MSF staff to describe and analyse the programmatic approach.

Case Description: MSF delivered programmes with thalassaemia investigations, provision of blood transfusion, iron chelation therapy, and psychosocial support. Thalassemia programmes were novel for the organisation and operational learning took place alongside service implementation. Lessons were identified on equipment procurement and the requirements for the implementation of vital investigations (including ferritin testing), to inform clinical decision making. Lessons included the importance of supply planning for sufficient blood products to meet diverse clinical needs in a conflict area, so those with thalassaemia have continued access to blood products among the competing priorities. Iron chelation therapy met a large need in this cohort. Adapted protocols were implemented to balance social factors, hygiene considerations, toxicity, tolerability, and adherence to therapy. Wider service needs included considerations for family planning advice and services, continuity of care and patient access through decentralised services or laboratory access, psychosocial support, and improved data collection including quality of life measurements to understand the full impact of such programmes.

Conclusions: Although this type of programming was not "routine" for the organisation, MSF demonstrated that life-sustaining thalassaemia care can be provided in complex conflict settings. International non-governmental organisations can consider this care possible in similar contexts.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903447PMC
http://dx.doi.org/10.1186/s13031-023-00503-2DOI Listing

Publication Analysis

Top Keywords

northeast syria
12
iron chelation
12
chelation therapy
12
thalassaemia
10
lessons identified
8
thalassaemia care
8
complex conflict
8
psychosocial support
8
blood products
8
conflict
5

Similar Publications

Objectives: In northeastern Syria (NES), the adherence of health care facilities to infection prevention and control (IPC) standards remains underexplored. This study evaluates the IPC performance of various health facilities against World Health Organization (WHO) benchmarks using the IPC Assessment Framework (IPCAF) and the Hand Hygiene Self-Assessment Framework (HHSAF).

Methods: We conducted a cross-sectional survey of 33 health care facilities, including primary (PHC), secondary (SHC), and tertiary health care centres (THC).

View Article and Find Full Text PDF
Article Synopsis
  • Individuals with a Prior Cancer History (PCH) are often excluded from clinical trials, but evidence suggests their past cancer history might not significantly affect their survival in brain cancer cases.
  • A retrospective study analyzed data from 42,726 brain cancer patients, with 2.78% having a PCH, highlighting genitourinary and breast cancers as the most common prior types.
  • While PCH was found to significantly increase the overall survival risk, it did not significantly impact brain cancer-specific survival, particularly in patients with glioblastoma or prior gastrointestinal and hematologic malignancies.
View Article and Find Full Text PDF

 On September 10, 2022, a cholera outbreak was declared in Syria for the first time in over a decade of protracted conflict. As of May 20, 2023, 132,782 suspected cases had been reported, primarily in northwest and northeast Syria. We aim to provide a detailed description of water sources and clinical status of a patient cohort seen at a cholera treatment center (CTC) in northwest Syria.

View Article and Find Full Text PDF
Article Synopsis
  • Attacks on healthcare during conflicts, like in Syria, really hurt health workers and their communities, even though some of them choose to stay and help despite the danger.
  • This research talked to 40 health workers, including a good number of women, about how these attacks affected their lives personally and at work.
  • The study found that the attacks caused serious psychological problems and stress, but also showed how health workers found ways to cope with the situation.
View Article and Find Full Text PDF

Evaluation of microbial and vancomycin treatments in ulcerative colitis in murine models.

PLoS One

May 2023

Department of Microbiology, Northeast Forestry University, Harbin, Heilongjiang, People's Republic of China.

Background: Despite the number of available therapies for ulcerative colitis (UC), severe side effects and high cost has limited their clinical application. Thus, finding new alternative strategies with minimal side effects is inevitable. Therefore, this study aimed to compare the effectiveness of different therapeutic approaches in DSS-induced colitis.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!