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Clinical Audit of Low Dose Prophylaxis Programme for Nigerian Children with Haemophilia
T U Nwagha1, H C Okoye1, C E Udo2
1Department of Haematology and Immunology, College of Medicine, University of Nigeria, Ituku Ozalla Campus, Enugu, Nigeria.
Insights
Low dose prophylaxis significantly reduced joint bleeds and improved joint function in Nigerian children with haemophilia. This treatment enhances quality of life, despite limited access in developing countries.
Area of Science:
- Pediatrics
- Hematology
- Public Health
Background:
- Low-dose prophylaxis is a proven treatment for haemophilia.
- Access to prophylaxis is limited for children in developing nations, including Nigeria.
Purpose of the Study:
- To audit the effectiveness of low-dose prophylaxis in Nigerian children with haemophilia.
- To assess improvements in joint bleeding, function, and quality of life.
Main Methods:
- A multicentre clinical audit involving five Nigerian haemophilia treatment centers.
- Eighteen children with haemophilia were enrolled in a low-dose prophylaxis program.
- Data collected on joint bleeds, joint function, and quality of life over a median of 7 months.
Main Results:
- A 74% overall reduction in joint bleeds was observed (162 to 42).
- Joint function improved in 94.1% of affected joints.
- School attendance, sports participation, and daily activities showed moderate to significant improvements.
Conclusions:
- Low-dose prophylaxis is beneficial for reducing joint bleeds in Nigerian children with haemophilia.
- The treatment improves joint function and overall quality of life.
- This highlights the importance of expanding access to such protocols in resource-limited settings.
Introduction:
The evidence of benefits for prophylaxis especially low dose prophylaxis is incontestable yet most children in developing countries as Nigeria do not have access to this treatment protocol.
Aim:
The aim was to audit the low dose prophylaxis treatment in Nigerian children with haemophilia.
Methodology:
A multicentre clinical audit of five haemophilia treatment centres; University of Nigeria Teaching Hospital Enugu, Lagos University Teaching Hospital, National Hospital Abuja, University of Port Harcourt Teaching Hospital Port Harcourt, and Federal Teaching Hospital Gombe. Eighteen children with mild-severe haemophilia were enrolled into low-dose prophylaxis treatment programme. The reduction of joint bleeding, improvement of joint function and Quality of Life (QoL) during prophylaxis were analysed.
Results:
In total 18 children - 17males and 1 female (median age 8 years) were enrolled. The median duration of observation was 7 months (range 3-15months). Seven of the children were on primary prophylaxis (41%) while 10 of the children (59%) were on secondary prophylaxis. The number of joint bleeds decreased from a total of 162 (individual range 5-20, mean 10.3) to 42 (range 0-7, mean 3.0) during the observation period with an overall reduction of 74%. Joint function improved in 94.1% of disease joints, while only 5.6% reported no improvement (due to poor compliance). School attendance improved in all subjects, sports participation and daily activity improved moderately.
Conclusion:
Low dose prophylaxis was beneficial in reduction of joint bleeds, improvement of joint function and improvement of QoL of Children with haemophilia in Nigeria.
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