PB0658 - Improvement in school absence after factor replacement in students with haemophilia in Upper Assam, India

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Anupam Dutta, MBBS, MD

Assistant Professor
Assam Medical College & Hospital
Dibrugarh, Assam, India

Co-Author(s)

TD

Taniya Sarkar Dutta

Assistant Professor
Assam Medical College and Hospital
Dibrugarh, Assam, India
DB

Dipjyoti Boruah

Research Assistant
Assam Medical College and Hospital
Dibrugarh, Assam, India

Background: Inadequately treated haemophilia patients experience complications related to repeated bleeding episodes caused by low levels of clotting factor VIII or IX in blood, that impacts day-to-day life, including active participation and performance in school in children with haemophilia (CwH). This complications can be prevented by factor replacement therapy, but access to factor has been challenging in low-resource settings such as Northeast India. This study shows the impact of this therapy on bleeding episodes, joint complications and school absence among CwH in this setting.

Aims: To evaluate the impact of factor replacement therapy on school absence in a tertiary care center of upper Assam, in North East India.

Methods: Inadequately treated haemophilia patients experience complications related to repeated bleeding episodes caused by low levels of clotting factor VIII or IX in blood, that impacts day-to-day life, including active participation and performance in school in children with haemophilia (CwH). This complications can be prevented by factor replacement therapy, but access to factor has been challenging in low-resource settings such as Northeast India. This study shows the impact of this therapy on bleeding episodes, joint complications and school absence among CwH in this setting.

Results: Thirty-eight CwH were eligible for the study; 26(68.4%) were on prophylactic-therapy and 12(31.5%) received on-demand therapy. Findings at the end of the study period were compared to that at the beginning. The mean (+SD) ABR in prophylactic therapy was 5.8(+4.6)(p < 0.001), HJHS was 4.7(+4.6) and FISH score was 27.9(+3.3)(p < 0.001), all suggested significant improvement. Prophylaxis showed better (but insignificant) results in comparison to on-demand therapy.

Conclusion(s): Factor replacement therapy significantly reduces school absence in CwH and correlates strongly with joint health and functional improvement, with the effect slightly better with prophylaxis than on-demand therapy.