HEADED by the Ministry of Public Health’s Hematology and Immunology Institute (IHI), the National Comprehensive Program for Patients with Primary Immunodeficiency began in Havana last year and is now a reality scheduled to extend to all the country’s provinces in a project covering the period 2013-2016.
The program’s objectives are to reduce risks of patient hospitalization or mortality, to implement general treatment and specialized hygiene care to prevent infection and other complications, and to meet vaccination targets in accordance with the type of deficiency, in coordination with National Immunization Program experts.
The program also plans to begin stem cell transplants as curative treatment, seek therapeutic alternatives for improved quality of life, evaluate and provide psychological care to patients and parents of pediatric patients, and to establish a follow-up plan via the primary healthcare system.
Dr. Consuelo Macías Abraham, director of the IHI Immunology Department, head of the National Immunology Group and a member of the new program offered this information during the recent Hematologia 2013 Conference in Havana’s International Convention Center, which brought together delegates from 40-plus countries.
Immunodeficiency is a pathological state in which the immune system fails to play its protective role, leaving the body vulnerable to infection.
Primary immunodeficiencies (PIDs) are disorders characterized by one or more congenital defects which provoke alterations in the quantity or quality of the components participating in immune response. They can be antibody defects, the most frequent; cell number and function defects or those of other components; and alterations in molecules essential to the system’s functioning.
Macías Abraham stated that there are 176 PID registered patients in Cuba, but that there is also a national sub-register. These patients can suffer from 150-plus illnesses, some of which are difficult to diagnose given their variability.
Immunology specialists are responsible for attending these patients in pediatric hospitals, clinical surgeries and research institutes nationwide.
The specialist noted that given the organization of the Cuban health system, "We work as a national immunology network," which facilitates diagnosis in high tech centers.
Hospital medicaments are supplied free of charge, a reality in the country given its social system, and expensive pharmaceuticals are available throughout the country, as are alternative therapies and community care in relation to social aspects of PID.
In response to a question from Granma as to the behavior of primary immunodeficiency, Dr Macías Abraham said that the deficiencies appear in the first five years of life, although 30% are diagnosed between adolescence and adulthood, and the basic manifestation consists of frequent infections of torpid evolution, although autoimmune, inflammatory and malignant processes also appear.
This inherited and congenital disorder due to genetic molecular defects of the immune system, is prevalent worldwide, and diagnosis is made through directed questions and physical examination and, depending on the PID type, may require laboratory examinations of greater or lesser complexity and imaginologics.