A survey of the management of idiopathic thrombocytopenic purpura in South Africa: Do we need guidelines for developing countries?
Introduction. Idiopathic thrombocytopenic purpura (ITP) is the most common bleeding disorder of childhood Aim. To describe the management of ITP in South Africa. Methods. A survey was sent to 410 doctors in the country, describing four different scenarios in children newly diagnosed with ITP and soliciting responses concerning the diagnosis and management. Results. Steroids were the first line of choice in treating ITP. Anti-D immunoglobulin was not considered in the management, and the most practitioners would perform a bone marrow aspiration even if no treatment with steroids would be given. The vast majority of the patients would be treated in hospital. Conclusions. This is the first study done in South Africa (and in Africa), and it shows a great variation in the management of children with newly diagnosed ITP. Prospective studies in developing countries where various constraints to health care delivery exist are required to produce evidence-based recommendations for this patient group.