LIMITATION ON SUPPORTING EXAMINATION FACILITIES FOR THALASSEMIA B MAJOR PATIENT MANAGEMENT ON ABDUL MANAF HOSPITAL

Aryanty, Nindya and Mustarim, mustarim and Harahap, Huntari (2020) LIMITATION ON SUPPORTING EXAMINATION FACILITIES FOR THALASSEMIA B MAJOR PATIENT MANAGEMENT ON ABDUL MANAF HOSPITAL. Unit Kerja dan Publikasi FKIK UNJA, Jambi. ISBN 978-602-73259-6-8

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Abstract

Background: Thalassemia B Major is a genetic illness characterized by anemia from an early age resulting in lifelong dependency on routine blood transfusions that increase risk of multi-organ dysfunction due to iron overload. In order to standardize management of thalassemia, Ministry of Health, in 2018, published the National Guidelines for Thalassemia Medical Service Management. Until now, research evaluating implementation of these guidelines in Indonesia has not been recorded. Method: This research qualitatively evaluate management of children with Thalassemia in Abdul Manaf Hospital in Jambi. The study conducted through an in-depth-interview with 13 children with Thalassemia who were treated at Abdul Manaf Hospital and their caregivers. The data triangulation carried out through interviews with the pediatricians and paramedics involved in the thalassemia services and by using field notes. Result: This research found the limitations on the supporting examinations facilities in the Thalassemia services at Abdul Manaf Hospital as a centre for thalassemia management in Jambi province. Unavailability in examining hemoglobin electrophoresis and DNA analysis hinder diagnostic conclusion. Evaluation of iron overload through ferritin measurement also not available. Considering an expensive cost for ferritin examinations in private laboratory, Ferritin measurement is only recommended once a year and encouraged through facilitated cost sharing by other parties. Evaluation of the side effect of iron chelation drugs on liver and kidney function is conducted once a year instead of every three months. MRI T2* to examine heart complications due to iron overload also not available at the hospital hence echocardiography examination is conducted to substitute the evaluation of heart function. Another problem arose since the Social Security Administrator for Health declare a policy to limit the payment of echocardiography examination only for those with abnormal result so then echocardiography is no longer used for heart complication screening for thalassemia patient. Conclusion: Limitations on the supporting examinations facilities in the Thalassemia services at Abdul Manaf Hospital affect the quality on the thalassemia management hence negatively influence the children’s health. Hospital directors need to urgently discuss with Jambi province government to fulfill all the equipment needed to be able to deliver high quality thalassemia management for the patient. Key word: limitation, supporting examination, health influence

Type:	Book
Subjects:	R Medicine > RJ Pediatrics R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions:	Fakultas Kedokteran dan Ilmu Kesehatan > Kedokteran
Depositing User:	Harahap
Date Deposited:	22 Mar 2021 01:07
Last Modified:	22 Mar 2021 01:07
URI:	https://repository.unja.ac.id/id/eprint/18979

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