Background: Managing of haemophilia patients in developing countries is a challenge. Strong interaction of patients with the interdisciplinary team working all together as one is the initial step.

Aims: Develop customized clinical rounds with ultrasound evaluation support, facilitate access to an all-in-one evaluation by the interdisciplinary team and bring medical assessment closer to the recreational environment are our main goals.

Methods: Data review was obtained from a personalized assessment of patients during a non medical environment medical approach. Interdisciplinary team is made up of hematologist, dentistry, radiologist, orthopedist, therapist and psychologists. Type of haemophilia, age, treatment, oral health and articular status were collected , including active joints that were needed to be studied by ultrasound (US).

Results: 23 haemophiliac patients data was collected, 22 were Haemophilia A patients, 19 jun severe (3 of them with inhibitors and 17 receiving prophylaxis), and one severe Haemophilia B. Target joints were present in a 60%, with ankle affection in 13 patients, 8 in knee and 5 in elbow. Although almost all patients felt asymptomatic, only 34 % demonstrated disease-free joint ultrasound. The rest presented synovial/cartilaginous/bone commitment including active bleeding in 2 patients that had to be infused. Odontological evaluation showed 56% of them had untreated caries.
Care strategies proposal has been based on 3 fundamentals:
1) Allow clinical round interdisciplinary evaluation to respond specific concerns and needs of each patient.
2) Establish personalized assessment from disciplines all together being carried out in one day
3) Optimize resources such as Ultrasound, an economic, harmless and highly diagnostic method, accessible to all levels of care.
Widely proven to be unconditional support in the Haemophiliac clinical evaluation.

Conclusions: Dynamic and fused coordination of a highly committed interdisciplinary team is the key to our achievements, adapting to patients needs and to our economic reality of developing south American country.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/haemophilia-breakthrough-in-developing-countries-is-it-possible/