Which plays a more important role in hemophilia treatment, economical development or medical technology?

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Dan Yu, Shu Yang, Hongli Mu, Zeping Zhou, Yiting Zhang, Jialing Tang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4015158/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective : To investigatethe management status of hemophilia A patients in Fujian, Guangxi and Yunnan provinces in South China and their gaps with the national data. To explore which plays a more important role in hemophilia treatment, economical development or medical technology? Methods : The data of hemophilia A patients registered in Fujian, Guangxi and Yunnan provinces were analyzed, and their diagnosis and treatment were studied and compared with the published national data. Results : 542 hemophilia A cases were registered in Fujian, including mild ones 6.3%, moderate 73.2%, severe 12.6% and unknown 7.9%; 295 cases in Guangxi, mild 4.7%, moderate 22.7%, severe 30.5% and unknown 42.1%; 162 cases in Yunnan, mild 7.4%, moderate 45.1%, severe 42.6% and unknown 4.9%. The proportion of patients with severe hemophilia A in Fujian was significantly lower than that in Guangxi, Yunnan and national data ( P < 0.05). Approximately29.2% had a delayed diagnosis in Guangxi (24.1% in Yunnan, 4.1% in Fujian, national data: 28.8%; P =0.000). The rate of delayed treatment is 17.3% in Guangxi, 4.9% in Yunnan,1.5% in Fujian and 39.2% in national data. The rate of joint deformity is 67.9% in Yunnan, 40.4% in Guangxi, 36% in national data and 17.0% in Fujian. The prophylactic treatmentrates in Guangxi and Yunnan were 16.9% and 27.2% respectively, which were statistically significant compared with the national rate (16.2%). Conclusion : Diagnosis and treatment status of hemophilia A in the three southern provinces of China are significantly different from the national data. In hemophilia treatment, economical development plays a more important role.At similar economic levels, medical technology will cause a gap in the level of hemophilia treatment. hemophilia economical development delayed diagnosis prophylactic treatments joint deformity 1. Introduction Hemophilia is a hereditary hemorrhagic disease with X-linked recessive inheritance. This disease is characterized by abnormalities in clotting factor Ⅷ or IX caused by mutations in the genes encoding these factors. The prevalence of the disease is approximately 17.1 per million male population [ 1 ]. Patients with hemophilia A may experience pain, swelling, joint arthropathy, intracranial hemorrhage, and other life-threatening events due to spontaneous bleeding of the joints or muscles [ 2 ]. Joint arthropathy is one of the most common complications of severe hemophilia [ 3 ]. Hemophilia A treatment aims to reduce the risk of long-term complications related to joint injury and improve the quality of life by prophylaxis and treating bleeding [ 2 , 4 ]. Through social and economic development and improvement, the overall level of diagnosis and treatment of hemophilia in China has significantly improved. However, China has a vast territory and large population, and a gap exists between hemophilia diagnosis and treatment in different regions. Fujian, Guangxi and Yunnan are three provinces in southern China, Fujian is located in the southeast coast of China, Guangxi is located in the autonomous area of ethnic minorities in southwest China. and Yunnan is located in southwest China, is the province with the largest variety of ethnic groups in China. According to the per capita GDP ranking of 31 provinces in China in 2022, Fujian, Yunnan and Guangxi ranked 4th, 23rd and 29th respectively, with 126845 yuan ( $ 17378.9), 61736 yuan ( $ 8458.4) and 52215 yuan ( $ 7153.9) respectively [ 5 ]. In this study, we aimed to investigate the gap between the diagnosis and treatment of haemophilia in the three southern provinces and the entire China and its causes. We explored economic development and medical technology, and which one has a greater impact on the diagnosis and treatment of hemophilia. The study may help improve the comprehensive care level of haemophilia patients. 2. Materials and Methods The data of hemophilia patients registered in Fujian (2016.3-2023.3), Guangxi (2017.1-2021.11) and Yunnan (2018.3-2023.4) were analyzed retrospectively, and compared with the published national data (2007–2019) [ 9 ]. The diagnosis information, treatment strategy (episodic and prophylactic treatment), joint deformities, and FVIII inhibitor status were retrospectively abstracted from medical records. In September 2021, an online survey (Sojump, a professional online survey platform) was conducted among hemophiliacs in Guangxi to determine the reasons for the gap between the diagnosis and treatment status of hemophilia in Guangxi Province and the entire country. Overall, 170 available questionnaires were collected, and the results were analyzed. SPSS22.0 software was used for statistical analysis. The measurement data of normal distribution are expressed by mean ± standard deviation, the measurement data of non-normal distribution are expressed by median and the counting data are expressed by frequency (%). The counting data are compared by χ 2 test, and the measurement data are compared by chi-square test or KruskalWallisH test of nonparametric test. Statistical significance was set at p < 0.05. The ethics committees of participating institutions approved the research protocol. The research was conducted following the Declaration of Helsinki. 3. Results Data analysis was conducted on hemophilia A patients registered in the three provinces: 542 patients were registered in Fujian Province, 295 in Guangxi, and 162 in Yunnan Province. The data was compared with 17779 cases of hemophilia A nationwide [9]. 3.1. Clinical characteristics In Fujian, there were 542 cases of hemophilia A, including 34 cases of mild (6.3%), 397 cases of moderate (73.2%),68 cases of severe (12.6%) and 43 cases of unknown (7.9%). The total data of 162 cases in Yunnan Province were mild in 12 cases (7.4%), moderate in 73 cases (45.1%), severe in 69 cases (42.6%) and 8 cases of unknown (4.9%). The mild, moderate,severe and unknown cases of 295 patients in Guangxi were 14 (4.7%), 67 (22.7%)，90 (30.5%) and 124(42.1%), respectively. The proportion of severe hemophilia A in Fujian was lower than that in Guangxi, Yunnan and the entire China ( P < 0.05), but there was no significant difference between Guangxi, Yunnan and the entire China (Table 1). Diagnostic delay was defined as a difference between the age of the first diagnosis and that of the first bleeding. In terms of delayed diagnosis of hemophilia A, the proportion of delayed diagnosis is 29.2% in Guangxi, 24.1% in Yunnan, and 4.1% in Fujian, respectively. The proportion of delayed diagnosis in Yunnan and Guangxi are similar to the national average data (28.8%). While the proportion of delayed diagnosis in Fujian is significantly lower than the entire China. Treatment delay was defined as a difference between the age of the first replacement therapy and that of the first bleeding. 17.3% of patients in Guangxi have delayed treatment, while Yunnan (4.9%) and Fujian (1.5%) have lower proportion than Guangxi and are significantly lower than the proportion of delayed treatment (39.2%) in the national data. 3.2. Bleeding manifestations, joint arthropathies, and related surgery The data of joint bleeding in the published national data is missing, and there is no significant difference in joint bleeding rates among Guangxi, Fujian and Yunnan provinces, which are 31.9%, 69.0% and 84.6% respectively. However, there is a significant difference in joint deformities among the three provinces, with the highest joint deformity rate in Yunnan (67.9%) and Guangxi (40.4%), and the lowest in Fujian (17.0%). Compared with the national data (36%), the joint deformity rate in Fujian is significantly lower, while the joint deformity rate in Yunnan and Guangxi is significantly higher than the national average data. Table 2 lists the specific site of joint deformities of hemophilia A patients in the three provinces. Knee joints and elbow joints are the most common joint deformity sites. 3.3. Treatment strategy The prophylactic treatment rate of hemophilia A patients in Yunnan (27.2%) is higher than the national average data(16.2%). However, the prophylactic treatment rate in Fujian (7.8%) is lower than the national average data. While the prophylactic treatment rate in Guangxi (16.9%) is similarity with the national average data. There is no significant difference in the duration and frequency of prophylactic treatment among the patients in the three provinces, most of them are more than 24 months, 2-3 times a week, and most of the doses of prophylactic treatment are FⅧ15-20IU/kg. In the proportion of the patients with prophylactic treatment doses greater than 10IU/kg, Fujian (88.9%) seems to be more than Guangxi (76.8%), but there is no statistical difference (Table 3). In addition, the positive rates of inhibitor of hemophilia A patients in Guangxi, Fujian and Yunnan provinces were 10.5%, 9.2% and 13.6%, respectively. Yunnan was slightly higher than the other two provinces, but it was not statistically significant. 3.4. Questionnaire survey of diagnosis and treatment status In order to understand the reasons for the gap between the haemophilia management in Guangxi and the national level, questionnaires were distributed to 290 patients who could be contacted, and 170 valid questionnaires were collected. These patients had lived in the 14 prefecture-level cities in Guangxi for a long time. Of these patients, 144 had haemophilia A (84.7%), while 26 (15.3%) had haemophilia B. The age range was 1–56 years, the average age was 17.4 years, and the median age was 14 years (Table 5). 4. Discussion As a developing country, China faces problems related to hemophilia management, such as poor healthcare infrastructure, poor management of registries, lack of reimbursement schemes, and low usage of prophylactic treatment [ 10 ]. China’s medical coverage system is complex and varies significantly among cities. Most hospitals with the capacity to diagnose and care for patients with hemophilia are located in the east of the country along the more economically developed coastline. Patients living in smaller cities and rural areas are frequently misdiagnosed or not diagnosed at all; the treatment programs available in these areas are limited, and treatment is usually neither available nor affordable [ 11 ]. Although Fujian, Yunnan, and Guangxi are all located in the southern part of China, there is a significant gap in economic and medical levels among the three provinces. Our results show that Fujian Province is better than the national average level in the overall diagnosis and treatment of hemophilia, and Yunnan Province and Guangxi Province are worse than the national average level. Compared with Yunnan, Guangxi and the national average level, the proportion of severe hemophilia A in Fujian is significantly lower, the diagnosis and treatment in Fujian are moretimely, and the proportion of joint deformity in Fujian is lower. The results show that the level of diagnosis and treatment of haemophilia is relatively high in Fujian Province, which is consistent with the per capita GDP ranking among the top in the country. Therefore, the diagnosis and treatment level of hemophilia may be related to the local economic situation. The research results of Dong Chaohui et al. show that for Chinese hemophilia patients, the required treatment cost for on-demand or low-dose prophylactic treatment is 50000 to 100000 yuan per year, while for prophylactic treatment, it can be as high as 200000 yuan per year [ 12 ]. A research result shows that in multiple cities in China, the average unit price of factor Ⅷ is 2.32–3.78 yuan, and the standard prophylactic dose for patients with severe hemophilia an is weekly 60 ~ 95IU/kg [ 13 ]. Therefore, the minimum annual cost of coagulation factor is more than 300000 yuan (about $ 43562.7). The annual payment limit of chronic disease insurance for hemophilia residents in Fujian is 120000 yuan (about $ 16718.7), while the annual payment limit for Yunnan and Guangxi is 80, 000 yuan (about $ 11616.72) per person [ 6 – 8 ]. Therefore, the payment amount of hemophilia medical insurance in Fujian Province is higher than that in Yunnan and Guangxi, which also contributes to the higher level of hemophilia treatment in Fujian Province to a certain extent. It can also be seen that the frequency of prophylactic treatment in Fujian is mostly 2–3 times per week and > 3 times per week, and the dose of prophylactic treatment is higher than that in Guangxi. Therefore, the level of diagnosis and treatment of hemophilia is related to the local economic situation and health insurance policy. However, in Yunnan and Guangxi, where the per capita GDP is similar, the proportion of delayed diagnosis and treatment of hemophilia in Yunnan is significantly lower than that in Guangxi. Therefore, there are factors other than socio-economic conditions that affect the level of diagnosis and treatment of hemophilia, such as the technical level of medical staff, the awareness of hemophilia knowledge among grassroots hospitals and the general public, and so on. In view of the relatively low level of diagnosis and treatment of hemophilia in Guangxi, a questionnaire survey was conducted on patients with hemophilia. The survey results show that there are several reasons for the low diagnostic level. Firstly, 77.6% of the patients were diagnosed in tertiary hospitals. Secondly, it is difficult for 62.4% of the patients to find a hemophilia specialist when seeking medical treatment in Guangxi; Thirdly, 61.7% of the patients are unable to receive treatment at hemophilia treatment centers; Finally, 90.5% of the patients chose the "hemophilia group" organized by patients as the main source of hemophilia related information. As of December 2022, Guangxi, a province with a population of over 50 million, has only two "hemophilia treatment centers" certified by the China Rare Disease Alliance and the China Hemophilia Collaborative Group. Due to the insufficient understanding of hemophilia in most grassroots hospitals, it is difficult for hemophilia patients to obtain accurate and reasonable diagnosis and provide appropriate treatment, which inevitably leads to a high rate of delayed diagnosis and subsequent high incidence of joint deformities. On the other hand, the survey results indicate that there are several reasons for the low treatment level and high incidence of joint deformities in hemophilia patients. Firstly, the supply of coagulation factors is insufficient, with 34.1% of patients unable to obtain coagulation factors in local hospitals, and only 9.4% of patients believing that the hospital factor supply is sufficient. Secondly, there is insufficient understanding of the disease and outdated treatment concepts. Only 39.4% of the patients receive long-term prophylactic treatment, 24.7% of patients undergo annual inhibitor testing, and 12.3% of patients undergo self-injection. Thirdly, the economic level is relatively low. Among the hemophilia A patients surveyed, 45.3% of their families have a monthly income below 3000 yuan (approximately $ 434.4), and some patients are unemployed. However, the monthly cost of paying for coagulation factors (after medical insurance reimbursement) in the survey is above 3000 yuan. Therefore, the high cost of coagulation factors has become a heavy burden on families. The prophylactic replacement of coagulation factors is considered the most effective strategy to reduce the risk of bleeding in patients with severe hemophilia [ 14 , 15 ]. However, the high treatment costs make it difficult for hemophilia A patients in Guangxi to adhere to preventive treatment. This can explain the extremely low level of prophylactic treatment in Guangxi. Overall, the socio-economic level, medical insurance policies and the level of diagnosis and treatment by grassroots doctors are the main influencing factors for the quality of hemophilia management. The economy is the basis for the influence of diagnosis and treatment of hemophilia. At similar economic levels, medical technology creates a gap. Therefore, it is necessary to pay attention to the balanced development of different regions, strengthen the construction of hemophilia treatment centers, improve the level of hemophilia diagnosis and treatment in hospitals at all levels. In addition, studies have shown that low-dose prophylaxis is effective and can be implemented in economically disadvantaged areas [ 16 , 17 ]. Through these means, the accessibility of medical treatment and the accessibility of reasonable diagnosis and treatment can be improved for hemophilia patients. Although this study is a retrospective study and the data from various centers are not strictly the same period as the national data, there is still relatively consistent comparability. Further multicenter prospective research is needed. 5. Conclusions Compared with the national data, there are statistical differences in the diagnosis and treatment of hemophilia in Fujian, Guangxi and Yunnan provinces in southern China. The local economic level, medical insurance status and doctors' diagnosis and treatment level have a great impact on the diagnosis and treatment of hemophilia. The economical development plays a more important role in hemophilia treatment. At similar economic levels, medical technology will cause a gap in the level of hemophilia treatment. Declarations Acknowledgments The authors are grateful to all patients who participated in our study. Conflict of interest statement The authors declare that they have no conflicts of interest. Consent for publication Not applicable Funding This work was supported by Self-funded Research Projects of Guangxi Zhuang Autonomous Region Health Department (Z20181007); and Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S2018085). Author contributions All authors contributed to the study conception and design. Yinghui Lai and Meijuan Huang were responsible for study design and review. JialingTang, Hongli Mu and Zeping Zhou responsible for data collection of each participating unit. Dan Yu and Shu Yang analyzed the data, interpreted the results, and wrote the original draft. Yiting Zhang reviewed and edited the manuscript. Data availability statement Data supporting the findings of this study are available from the corresponding author upon reasonable request. Ethics approval Ethical approval to report this case was obtained from * The Medical Ethics Committees of Second Affiliated Hospital of Guangxi Medical University (2023-KY (0633)) *. Informed consent Verbal informed consent was obtained from a legally authorized representative(s) for anonymized patient information to be published in this article. References Iorio A, Stonebraker JS, Chambost H, et al. Establishing the prevalence and prevalence at birth of hemophilia in males: A meta-analytic approach using national registries. Ann Intern Med. 2019;171(8):540–6. 10.7326/M19-1208 . Rayment R, Chalmers E, Forsyth K, et al. Guidelines on the use of prophylactic factor replacement for children and adults with haemophilia A and B. Br J Haematol. 2020;190(5):684–95. 10.1111/bjh.16704 . Rodriguez-Merchan EC. Articular bleeding in hemophilia. Cardiovasc Hematol Disord Drug Targets. 2016;16(1):21–4. 10.2174/1871529x16666160613114506 . Berntorp E, Hermans C, Solms A, Poulsen L, Mancuso ME. Optimising prophylaxis in haemophilia A: the ups and downs of treatment. Blood Rev. 2021;50:100852. 10.1016/j.blre.2021.100852 . National Bureau of Statics of China. National Data. https://data.stats.gov.cn Accessed 11 March 2023. Medical Security Bureau of Fu Jian Provincial. https://ybj.fujian.gov.cn/ Accessed July 1, 2023. Medical Security Bureau of Yun Nan Provincial. https://ylbz.yn.gov.cn/ Accessed July 1, 2023. Medical Security Bureau of Guangxi Zhuang Autonomous Region. http://ybj.gxzf.gov.cn/ Accessed July 1, 2023. Song X, Zhong J, Xue F, et al. An overview of patients with haemophilia A in China: Epidemiology, disease severity and treatment strategies. Haemophilia. 2021;27(1):e51–9. 10.1111/hae.14217 . Pratap R, Misra M, Morampudi NV, Patil S, Reddy A. The existing scenario of haemophilia care in Canada and China – A review. Hematol Transfus Cell Ther. 2020;42(4):356–64. 10.1016/j.htct.2019.08.001 . Ozelo MC, Matta MA, Yang R. Meeting the challenges of haemophilia care and patient support in China and Brazil. Haemoph 2012; 18;Suppl 5: 33–810.1111/j.1365-2516.2012.02890.x. Dong Zhaohui. ChenBinbin, Li Zhongqi.Medical Insurance and Management Analysis of Hemophilia—Based on the Experience of Shenzhen. China Health Insurance 2018 No.112(01):32–5. 10.19546/j.issn.1674-3830.2018.1.007.[Chinese] . He X, Wang X, Dong C, Zhao M, Wu J. The long-term clinical benefits and economic costs associated with increased use of prophylaxis among patients with haemophilia A in China: population-based predictions from 2018 to 2033. Haemophilia. 2022;28(5):726–36. 10.1111/hae.14603 . Thorat T, Neumann PJ, Chambers JD. Hemophilia burden of disease: A systematic review of the cost-utility literature for hemophilia. J Manag Care Spec Pharm. 2018;24(7):632–42. 10.18553/jmcp.2018.24.7.632 . Srivastava A, Brewer AK, Mauser-Bunschoten EP, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19(1):e1–47. 10.1111/j.1365-2516.2012.02909.x . Tang L, Wu R, Sun J, et al. Short-term low-dose secondary prophylaxis for severe/moderate haemophilia A children is beneficial to reduce bleed and improve daily activity, but there are obstacle in its execution: a multi-centre pilot study in China. Haemophilia. 2013;19(1):27–34. 10.1111/j.1365-2516.2012 . 02926. x. Sun J, Zhou X, Hu N. Factor VIII replacement prophylaxis in patients with hemophilia A transitioning to adults: a systematic literature review. Orphanet J Rare Dis. 2021;16(1):287. 10.1186/s13023-021-01919-w . Published 2021 Jun 26. Tables Table 1. Comparison between the data of hemophilia A in three provinces of south China and that in China Parameter Entire China Fujian Guangxi Yunnan P1 * P2 ** P 3 *** Family history Yes 5038（28.3%） 196（36.2%） 93（31.5%） 48（29.6%） 0.00 0.23 0.72 No/unknown 12741(71.7） 346（63.8%） 202 (68.5%） 114（70.4%） disease severity, n (%) Mild 1809（10.2%） 34 （6.3%） 14（4.7%） 12（7.4%） 0.00 0.45 0.22 Moderat 4788（26.9%） 397（73.2%） 67（22.7%） 73（45.1%） Severe 6519（36.7%） 68 （12.6%） 90（30.5%） 69（42.6%） Unknown 4663（26.2%） 43（7.9%） 124（42.1%） 8（4.9%） Delayed diagnosis,n (%) Yes 1437（28.8%） 22（4.1%） 86（29.2%） 39 （24.1%） 0.00 0.00 0.21 No 3560（71.2%） 392（72.3%） 91（30.8%） 123（75.9%） unknown 0（0%） 128（23.6%） 118（40.0%） 0（0%） Delayed treatment,n (%) Yes 1750（39.2%） 8（1.5%） 51 （17.3%） 8 （4.9%） 0.00 0.00 0.00 No 2714（60.8%） 217（40.0%） 126（42.7%） 148（91.4%） unknown 0（0%） 317（58.5%） 118（40.0%） 6（3.7%） Joint arthropathy, n (%) Yes 1436（36%） 92 （17.0%） 119（40.4%） 110（67.9%） 0.00 0.00 0.00 No 2561（64%） 348（64.2%） 80 （27.1%） 52 （32.1%） unknown 0（0%） 102（18.8%） 96（32.5%） 0（0%） Treatment strategy, n (%) Prophylactic treatment 425 （16.2%） 42(7.8%) 50 （16.9%） 44（27.2%） 0.00 0.00 0.001 Episodic treatments 1162（44.3%） 160(29.5%) 122（41.4%） 63（38.9%） Other 1033（39.5%） 33(6.1%) 26 （8.8%） 55（33.9%） unknown 0（0%） 307(56.6%) 97（32,9%） 0（0%） Factor VIII inhibitor positive 50 （9.2%） 31 （10.5%） 22 (13.6%) Negative 260（48.0%） 122（41.4%） 108(66.7%) unknown 232（42.8%） 142（48.1%） 32(19.7%) * P1 mean Fujian vs Entire China. ** P2 show Guangxi vs Entire China. *** P 3 represent Yunnan vs Entire China. Table 2. The specific site of joint arthropathy in Guangxi, Fujian and Yunnan provinces Joint Left shoulder （ n ） Right shoulder （ n ） Left elbow （ n ） Right elbow （ n ） Left wrist （ n ） Right wrist （ n ） Left hip （ n ） Right hip （ n ） Left knee （ n ） Right knee （ n ） Left ankle （ n ） Right ankle （ n ） Guangxi 7 11 30 35 7 8 13 11 83 86 15 24 (5.9%) (9.2%) (25.2%) (29.4%) (5.9%) (6.7%) (10.9%) （9.2%） （69.7%） （72.3%） (12.6%） (20.2%) Fujian 3 5 19 35 0 2 19 19 26 16 4 1 (3.3%) (5.4%) (20.7%) (38.0%) (0%) (2.2%) (20.7%) (20.7%) (28.3%) (17.4%) (4.3%) (1.1%) Yunnan 3 2 17 22 8 6 14 19 64 62 23 23 (2.7%) (1.8%) (15.5%) (20.0%) (7.3%) (5.5%) (12.7%) (17.3%) (58.2%) （56.4%） （20.9%） （20.9%） Table 3. Prophylactic treatment in Guangxi, Fujian and Yunnan provinces Prophylactic treatments Fujian (n=72) Guangxi (n=69) Yunnan (n=69) P 1 * P2 ** Duration of prophylactic treatment ≤3 months 3 to ≤6 months 6 to ≤12 months 12 to ≤24 months >24 months 5（6.9%） 5（6.9%) 10(13.9%) 11 (15.3%) 41 (57.0%) 1 （1.4%） 6 （8.7%） 18（26.1%） 11（16.0%） 33（47.8%） 1 （1.4%） 4 （5.7%） 8 （11.6%） 16（23.2%） 40（58.0%） 0.40 0.10 Frequency of prophylactic treatment 1 time/week 2–3 times/week >3 times/week 14（19.5%） 53（73.6%） 5 （6.9%） 19（27.5%） 49（71.1%） 1 （1.4%） 11（16.0%） 58（84.0%） 0 （0%） 0.06 0.15 Dose of prophylactic treatment 10u/kg 10-15 u/kg 15-20 u/kg ＞20 u/kg unknown 8 （11.1%） 15（20.8%） 28（38.9%） 11（15.3%） 10（13.9%） 16 (23.2%) 14 (20.3%) 24（34.8%） 15（21.7%） 0 （0%） 13 (18.9%) 14 (20.3%) 25（36.2%） 17（24.6%） 0 （0%） 0.55 0.53 * P 1 show Guangxi vs Fujian . ** P2 mean Guangxi vs Yunnan . Table 4. Questionnaire survey on diagnosis and treatment of hemophiliac in Guangxi Hemophilia A+B（N=170） N (%) Hemophilia A 144 (84.7%) Hemophilia B 26（15.3%） Type of hospital where the patient was diagnosed Grade-A Secondary hospital 7（4.1%） Grade-B Secondary hospital 1（0.6%） Grade-A Tertiary hospital 132（77.6%） Not clear 30（17.7%） Can coagulation factors be obtained at local hospitals？ Yes 112（65.9%） No 58（34.1%） Supply status of clotting factors in hospitals at ordinary times Adequate supply 16（9.4%） Often in short supply 33（19.4%） Occasionally, in short supply 121（71.2%） Prophylactic treatment status I don’t know what prophylactic treatment is 35（20.6%） Never received prophylactic treatment. 10（5.9%） Occasional prophylactic treatment 58（34.1%） Long-term prophylactic treatment 67（39.4%） Annual testing for the presence of inhibitors Never been tested 63（37.1%） No, a test is taken if the doctor advises doing so. 65（38.2%） Yes, it is tested every year. 42（24.7%） Do you know the method of injecting on your own/child？ No 69（40.6%） I did, but I was afraid to inject 80（47.1%） Yes, I often inject myself/my children. 21（12.3%） Will the clotting factor be used immediately when there is bleeding? Do not use it when there is less bleeding; use it only when the bleeding does not stop. 30（17.6%） Depending on the clotting factor reserve, use it when the reserve is sufficient. 19（11.2%） Use clotting factor immediately 121（71.2%） Do you go to the hemophilia center for your usual treatment？ No 114（61.7%） Yes 56（32.9%） Do you record your clotting factor use？ No record of it 54（31.8%） Record occasionally 37（21.8%） Frequently record 34（20%） Record every time 45（26.5%） Is it easy to find hemophilia professionals when seeing a doctor in Guangxi? Easy 64（37.6%） Not easy 106（62.4%） Monthly expenses for payment of clotting factors (after reimbursement of medical insurance) Valid data（3374.55 ± 393.516 yuan） 149（87.6%） Not calculated or not clear 21（12.4%） Monthly household income More than 20,000 yuan 2（1.2%） 10,000–20,000 yuan 4（2.3%） 5,000–10,000 yuan 21（12.4%） 3,000–5,000 yuan 66（38.8%） Less than 3,000 yuan 77（45.3%） Employment/academic status Working/studying 114（67.1%） Unemployed/out of school 56（32.9%） Types of medical insurance Medical insurance for urban employees 11（6.5%） Urban employee medical insurance + commercial insurance 2（1.2%） New rural cooperative medical insurance 157（92.3%） Sources of information on hemophilia (choose three items) Rarely pay attention to this knowledge 3（1.7%） Expert lectures at hemophilia exchange meetings 99（58.2%） The doctor and nurse inform 71（41.7%） Books/newspapers 40（23.5%） WeChat Official Account 70（41.4%） Hemophiliac group 154（90.5%） What kind of help do you want doctors and nurses to provide? (Multiple selections) Build a communication platform to establish close contact with other patients 75（44.1%） Teach me how to inject clotting factor by myself to improve the success rate of injection 86（50.5%） Teach me some simple rehabilitation exercises so that I can exercise by myself Encouraged by doctors and nurses 122（71.7%） Carry out onsite injection service Provide frontier knowledge of hemophilia treatment 61（35.8%） Instruct me to calculate the dosage of a clotting factor according to the bleeding status 59（34.7%） Others 96（56.5%） What are your expectations for the future treatment of hemophilia (fill in the blank) Blank 21（12.4%） Increase in medical insurance quota and reimbursement ratio 65（43.6%） Sufficient drug supply in county-level hospitals 12（8%） Other 51（34%）_ Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4015158","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":307788664,"identity":"7d18472a-dedb-47e8-ad85-a13fd419342d","order_by":0,"name":"Dan Yu","email":"","orcid":"","institution":"The Second Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Dan","middleName":"","lastName":"Yu","suffix":""},{"id":307788665,"identity":"cf3f46a4-931c-4d26-b3e0-d371e92da406","order_by":1,"name":"Shu Yang","email":"","orcid":"","institution":"Fujian Medical University Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shu","middleName":"","lastName":"Yang","suffix":""},{"id":307788666,"identity":"87dab1f4-a807-4eea-aac0-904516b20903","order_by":2,"name":"Hongli Mu","email":"","orcid":"","institution":"Kunming Medical University Second Hospital: Kunming Medical University Second Affliated Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hongli","middleName":"","lastName":"Mu","suffix":""},{"id":307788667,"identity":"799c9289-e483-487e-8cf5-603f62eeb6f1","order_by":3,"name":"Zeping Zhou","email":"","orcid":"","institution":"Kunming Medical University Second Hospital: Kunming Medical University Second Affliated Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zeping","middleName":"","lastName":"Zhou","suffix":""},{"id":307788668,"identity":"971781db-81c7-4ba0-a710-04a38ba950c1","order_by":4,"name":"Yiting Zhang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABB0lEQVRIie2QMUvDQBTHXzi4Lte6nliMH+FJoOpUP8pzsUsqjhk61OWyBHcXP4bzhYO6RLIWXCIuDh0Ul1SKehEKLsmtgvcb/vc43o/HewAez1+EAejmxSYome3zXqodCvulVMUiGoiC3GO2SvCk2NmtPMVOAe93cnP5AeOj3oN5Ic4nSgJBndy1K4aBubkGdpJdnB+TGE7V3pUOsuKxW+lnwFHHIyTJp2qoiQXKrQgsV1ZBNuHSplMRNUhcxlFFxMip7BqGpj8HxOVqBKQXh8oeOe/aZVDmz+9iA2Ms4+ht/TkLwzTNqzppVw60jUB9NTWX21/d2m8J501ufmr22tXp8Xg8/5dvz7JZIl99kSUAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0003-4125-9353","institution":"The Second Affiliated Hospital of Guangxi Medical University","correspondingAuthor":true,"prefix":"","firstName":"Yiting","middleName":"","lastName":"Zhang","suffix":""},{"id":307788669,"identity":"6ea9cf95-892a-4132-b332-1493f01284e3","order_by":5,"name":"Jialing Tang","email":"","orcid":"","institution":"The Second Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jialing","middleName":"","lastName":"Tang","suffix":""},{"id":307788670,"identity":"a87340c7-4a94-4e83-813c-6a14c9d93389","order_by":6,"name":"Meijuan Huang","email":"","orcid":"","institution":"Fujian Medical University Union Hospital","correspondingAuthor":false,"prefix":"","firstName":"Meijuan","middleName":"","lastName":"Huang","suffix":""},{"id":307788671,"identity":"89342547-e7cc-4304-a37e-7fe4ae99a024","order_by":7,"name":"Yinghui Lai","email":"","orcid":"https://orcid.org/0000-0002-7517-3630","institution":"The Second Affiliated Hospital of Guangxi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yinghui","middleName":"","lastName":"Lai","suffix":""}],"badges":[],"createdAt":"2024-03-05 04:22:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4015158/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4015158/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":67686957,"identity":"d7a09570-397c-4b53-b21f-b393eefeb054","added_by":"auto","created_at":"2024-10-28 16:48:23","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":848493,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4015158/v1/186b4954-9991-4feb-8fd2-71d7cd37c87e.pdf"}],"financialInterests":"","formattedTitle":"Which plays a more important role in hemophilia treatment, economical development or medical technology?","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eHemophilia is a hereditary hemorrhagic disease with X-linked recessive inheritance. This disease is characterized by abnormalities in clotting factor Ⅷ or IX caused by mutations in the genes encoding these factors. The prevalence of the disease is approximately 17.1 per million male population [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Patients with hemophilia A may experience pain, swelling, joint arthropathy, intracranial hemorrhage, and other life-threatening events due to spontaneous bleeding of the joints or muscles [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Joint arthropathy is one of the most common complications of severe hemophilia [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Hemophilia A treatment aims to reduce the risk of long-term complications related to joint injury and improve the quality of life by prophylaxis and treating bleeding [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Through social and economic development and improvement, the overall level of diagnosis and treatment of hemophilia in China has significantly improved. However, China has a vast territory and large population, and a gap exists between hemophilia diagnosis and treatment in different regions.\u003c/p\u003e \u003cp\u003eFujian, Guangxi and Yunnan are three provinces in southern China, Fujian is located in the southeast coast of China, Guangxi is located in the autonomous area of ethnic minorities in southwest China. and Yunnan is located in southwest China, is the province with the largest variety of ethnic groups in China. According to the per capita GDP ranking of 31 provinces in China in 2022, Fujian, Yunnan and Guangxi ranked 4th, 23rd and 29th respectively, with 126845 yuan (\u003cspan\u003e$\u003c/span\u003e17378.9), 61736 yuan (\u003cspan\u003e$\u003c/span\u003e8458.4) and 52215 yuan (\u003cspan\u003e$\u003c/span\u003e7153.9) respectively [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn this study, we aimed to investigate the gap between the diagnosis and treatment of haemophilia in the three southern provinces and the entire China and its causes. We explored economic development and medical technology, and which one has a greater impact on the diagnosis and treatment of hemophilia. The study may help improve the comprehensive care level of haemophilia patients.\u003c/p\u003e"},{"header":"2. Materials and Methods","content":"\u003cp\u003eThe data of hemophilia patients registered in Fujian (2016.3-2023.3), Guangxi (2017.1-2021.11) and Yunnan (2018.3-2023.4) were analyzed retrospectively, and compared with the published national data (2007\u0026ndash;2019) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The diagnosis information, treatment strategy (episodic and prophylactic treatment), joint deformities, and FVIII inhibitor status were retrospectively abstracted from medical records.\u003c/p\u003e \u003cp\u003eIn September 2021, an online survey (Sojump, a professional online survey platform) was conducted among hemophiliacs in Guangxi to determine the reasons for the gap between the diagnosis and treatment status of hemophilia in Guangxi Province and the entire country. Overall, 170 available questionnaires were collected, and the results were analyzed.\u003c/p\u003e \u003cp\u003eSPSS22.0 software was used for statistical analysis. The measurement data of normal distribution are expressed by mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, the measurement data of non-normal distribution are expressed by median and the counting data are expressed by frequency (%).\u003c/p\u003e \u003cp\u003eThe counting data are compared by χ 2 test, and the measurement data are compared by chi-square test or KruskalWallisH test of nonparametric test. Statistical significance was set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003cp\u003e The ethics committees of participating institutions approved the research protocol. The research was conducted following the Declaration of Helsinki.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eData analysis was conducted on hemophilia A patients registered in the three provinces: 542 patients were registered in Fujian Province, 295 in Guangxi, and 162 in Yunnan Province. The data was compared with 17779 cases of hemophilia A nationwide [9].\u003c/p\u003e\n\u003cp\u003e3.1. Clinical characteristics\u003c/p\u003e\n\u003cp\u003eIn Fujian, there were\u0026nbsp;542\u0026nbsp;cases of hemophilia A, including 34 cases of mild (6.3%), 397 cases of moderate (73.2%),68 cases of severe (12.6%)\u0026nbsp;and 43 cases of unknown (7.9%). The total data of 162\u0026nbsp;cases in Yunnan Province were mild in 12 cases (7.4%), moderate in 73 cases (45.1%),\u0026nbsp;severe in 69 cases (42.6%)\u0026nbsp;and 8 cases of unknown (4.9%).\u0026nbsp;The mild, moderate,severe\u0026nbsp;and unknown\u0026nbsp;cases\u0026nbsp;of\u0026nbsp;295\u0026nbsp;patients in Guangxi were 14 (4.7%), 67 (22.7%)，90 (30.5%)\u0026nbsp;and 124(42.1%), respectively.\u0026nbsp;The proportion of severe hemophilia A in Fujian was lower than that in Guangxi, Yunnan and the entire China (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), but there was no significant difference between Guangxi, Yunnan and the entire China (Table 1).\u003c/p\u003e\n\u003cp\u003eDiagnostic delay was defined as a difference between the age of the first diagnosis and that of the first bleeding. In terms of delayed diagnosis of hemophilia\u0026nbsp;A, the proportion of delayed diagnosis is\u0026nbsp;29.2% in Guangxi, 24.1% in Yunnan, and 4.1% in Fujian, respectively. \u0026nbsp;The proportion of delayed diagnosis in Yunnan and Guangxi are similar to the national average data (28.8%).\u0026nbsp;While the proportion of delayed diagnosis in Fujian is significantly lower than the entire China. Treatment delay was defined as a difference between the age of the first replacement therapy and that of the first bleeding. 17.3% of patients in Guangxi have delayed treatment, while Yunnan (4.9%) and Fujian (1.5%) have lower proportion than Guangxi and are significantly lower than the proportion of delayed treatment (39.2%) in the national data.\u003c/p\u003e\n\u003cp\u003e3.2. Bleeding manifestations, joint arthropathies, and related surgery\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp;The data of joint bleeding in the published national data is missing, and there is no significant difference in joint bleeding rates among Guangxi, Fujian and Yunnan provinces, which are\u0026nbsp;31.9%, 69.0% and 84.6% respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, there is a significant difference in joint deformities among the three provinces, with the highest joint deformity rate in Yunnan (67.9%) and Guangxi (40.4%), and the lowest in Fujian (17.0%). Compared with the national data\u0026nbsp;(36%), the joint deformity rate in Fujian is significantly lower, while the joint deformity rate in Yunnan and Guangxi is significantly higher than the national average data. Table 2 lists the specific site of joint deformities of hemophilia A patients in the three provinces. Knee joints and elbow joints are the most common joint deformity sites.\u003c/p\u003e\n\u003cp\u003e3.3. Treatment strategy\u003c/p\u003e\n\u003cp\u003eThe prophylactic treatment rate of hemophilia A\u0026nbsp;patients in Yunnan (27.2%) is higher than the national average data(16.2%). However, the prophylactic treatment rate in Fujian (7.8%) is lower than the national average data. While the prophylactic treatment rate in Guangxi (16.9%) is similarity with the national average data. There is no significant difference in the duration and frequency of prophylactic treatment among the patients in the three provinces, most of them are\u0026nbsp;more than\u0026nbsp;24 months, 2-3 times a week, and most of the doses of prophylactic treatment are FⅧ15-20IU/kg. In the proportion of the patients with prophylactic treatment doses greater than 10IU/kg, Fujian\u0026nbsp;(88.9%)\u0026nbsp;seems to be more than Guangxi (76.8%), but there is no statistical difference (Table 3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn addition, the positive rates of inhibitor of hemophilia A patients in Guangxi, Fujian and Yunnan provinces were 10.5%, 9.2% and 13.6%, respectively. Yunnan was\u0026nbsp;slightly higher than the other two provinces, but it was not statistically significant.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e3.4. Questionnaire survey of diagnosis and treatment status\u003c/p\u003e\n\u003cp\u003eIn order to understand the reasons for the gap between the haemophilia management in Guangxi and the national level, questionnaires were distributed to 290 patients who could be contacted, and 170 valid questionnaires were collected. These patients had lived in the 14 prefecture-level cities in Guangxi for a long time. Of these patients, 144 had haemophilia A (84.7%), while 26 (15.3%) had haemophilia B. The age range was 1\u0026ndash;56 years, the average age was 17.4 years, and the median age was 14 years (Table 5).\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eAs a developing country, China faces problems related to hemophilia management, such as poor healthcare infrastructure, poor management of registries, lack of reimbursement schemes, and low usage of prophylactic treatment [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. China\u0026rsquo;s medical coverage system is complex and varies significantly among cities. Most hospitals with the capacity to diagnose and care for patients with hemophilia are located in the east of the country along the more economically developed coastline. Patients living in smaller cities and rural areas are frequently misdiagnosed or not diagnosed at all; the treatment programs available in these areas are limited, and treatment is usually neither available nor affordable [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Although Fujian, Yunnan, and Guangxi are all located in the southern part of China, there is a significant gap in economic and medical levels among the three provinces.\u003c/p\u003e \u003cp\u003eOur results show that Fujian Province is better than the national average level in the overall diagnosis and treatment of hemophilia, and Yunnan Province and Guangxi Province are worse than the national average level. Compared with Yunnan, Guangxi and the national average level, the proportion of severe hemophilia A in Fujian is significantly lower, the diagnosis and treatment in Fujian are moretimely, and the proportion of joint deformity in Fujian is lower. The results show that the level of diagnosis and treatment of haemophilia is relatively high in Fujian Province, which is consistent with the per capita GDP ranking among the top in the country. Therefore, the diagnosis and treatment level of hemophilia may be related to the local economic situation. The research results of Dong Chaohui et al. show that for Chinese hemophilia patients, the required treatment cost for on-demand or low-dose prophylactic treatment is 50000 to 100000 yuan per year, while for prophylactic treatment, it can be as high as 200000 yuan per year [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. A research result shows that in multiple cities in China, the average unit price of factor Ⅷ is 2.32\u0026ndash;3.78 yuan, and the standard prophylactic dose for patients with severe hemophilia an is weekly 60\u0026thinsp;~\u0026thinsp;95IU/kg [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Therefore, the minimum annual cost of coagulation factor is more than 300000 yuan (about \u003cspan\u003e$\u003c/span\u003e43562.7). The annual payment limit of chronic disease insurance for hemophilia residents in Fujian is 120000 yuan (about \u003cspan\u003e$\u003c/span\u003e16718.7), while the annual payment limit for Yunnan and Guangxi is 80, 000 yuan (about \u003cspan\u003e$\u003c/span\u003e11616.72) per person [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Therefore, the payment amount of hemophilia medical insurance in Fujian Province is higher than that in Yunnan and Guangxi, which also contributes to the higher level of hemophilia treatment in Fujian Province to a certain extent. It can also be seen that the frequency of prophylactic treatment in Fujian is mostly 2\u0026ndash;3 times per week and \u0026gt;\u0026thinsp;3 times per week, and the dose of prophylactic treatment is higher than that in Guangxi. Therefore, the level of diagnosis and treatment of hemophilia is related to the local economic situation and health insurance policy.\u003c/p\u003e \u003cp\u003eHowever, in Yunnan and Guangxi, where the per capita GDP is similar, the proportion of delayed diagnosis and treatment of hemophilia in Yunnan is significantly lower than that in Guangxi. Therefore, there are factors other than socio-economic conditions that affect the level of diagnosis and treatment of hemophilia, such as the technical level of medical staff, the awareness of hemophilia knowledge among grassroots hospitals and the general public, and so on.\u003c/p\u003e \u003cp\u003eIn view of the relatively low level of diagnosis and treatment of hemophilia in Guangxi, a questionnaire survey was conducted on patients with hemophilia. The survey results show that there are several reasons for the low diagnostic level. Firstly, 77.6% of the patients were diagnosed in tertiary hospitals. Secondly, it is difficult for 62.4% of the patients to find a hemophilia specialist when seeking medical treatment in Guangxi; Thirdly, 61.7% of the patients are unable to receive treatment at hemophilia treatment centers; Finally, 90.5% of the patients chose the \"hemophilia group\" organized by patients as the main source of hemophilia related information. As of December 2022, Guangxi, a province with a population of over 50\u0026nbsp;million, has only two \"hemophilia treatment centers\" certified by the China Rare Disease Alliance and the China Hemophilia Collaborative Group. Due to the insufficient understanding of hemophilia in most grassroots hospitals, it is difficult for hemophilia patients to obtain accurate and reasonable diagnosis and provide appropriate treatment, which inevitably leads to a high rate of delayed diagnosis and subsequent high incidence of joint deformities. On the other hand, the survey results indicate that there are several reasons for the low treatment level and high incidence of joint deformities in hemophilia patients. Firstly, the supply of coagulation factors is insufficient, with 34.1% of patients unable to obtain coagulation factors in local hospitals, and only 9.4% of patients believing that the hospital factor supply is sufficient. Secondly, there is insufficient understanding of the disease and outdated treatment concepts. Only 39.4% of the patients receive long-term prophylactic treatment, 24.7% of patients undergo annual inhibitor testing, and 12.3% of patients undergo self-injection. Thirdly, the economic level is relatively low. Among the hemophilia A patients surveyed, 45.3% of their families have a monthly income below 3000 yuan (approximately \u003cspan\u003e$\u003c/span\u003e434.4), and some patients are unemployed. However, the monthly cost of paying for coagulation factors (after medical insurance reimbursement) in the survey is above 3000 yuan. Therefore, the high cost of coagulation factors has become a heavy burden on families. The prophylactic replacement of coagulation factors is considered the most effective strategy to reduce the risk of bleeding in patients with severe hemophilia [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, the high treatment costs make it difficult for hemophilia A patients in Guangxi to adhere to preventive treatment. This can explain the extremely low level of prophylactic treatment in Guangxi.\u003c/p\u003e \u003cp\u003eOverall, the socio-economic level, medical insurance policies and the level of diagnosis and treatment by grassroots doctors are the main influencing factors for the quality of hemophilia management. The economy is the basis for the influence of diagnosis and treatment of hemophilia. At similar economic levels, medical technology creates a gap. Therefore, it is necessary to pay attention to the balanced development of different regions, strengthen the construction of hemophilia treatment centers, improve the level of hemophilia diagnosis and treatment in hospitals at all levels. In addition, studies have shown that low-dose prophylaxis is effective and can be implemented in economically disadvantaged areas [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Through these means, the accessibility of medical treatment and the accessibility of reasonable diagnosis and treatment can be improved for hemophilia patients.\u003c/p\u003e \u003cp\u003e Although this study is a retrospective study and the data from various centers are not strictly the same period as the national data, there is still relatively consistent comparability. Further multicenter prospective research is needed.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eCompared with the national data, there are statistical differences in the diagnosis and treatment of hemophilia in Fujian, Guangxi and Yunnan provinces in southern China. The local economic level, medical insurance status and doctors' diagnosis and treatment level have a great impact on the diagnosis and treatment of hemophilia. The economical development plays a more important role in hemophilia treatment. At similar economic levels, medical technology will cause a gap in the level of hemophilia treatment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to all patients who participated in our study. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by Self-funded Research Projects of Guangxi Zhuang Autonomous Region Health Department (Z20181007); and Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project (S2018085).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the study conception and design. Yinghui Lai and Meijuan Huang were responsible for study design and review. JialingTang, Hongli Mu and Zeping Zhou responsible for data collection of each participating unit. Dan Yu and Shu Yang analyzed the data, interpreted the results, and wrote the original draft. Yiting Zhang reviewed and edited the manuscript. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData supporting the findings of this study are available from the corresponding author upon reasonable request.\u0026emsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval to report this case was obtained from * The Medical Ethics Committees of Second Affiliated Hospital of Guangxi Medical University (2023-KY (0633)) *.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVerbal informed consent was obtained from a legally authorized representative(s) for anonymized patient information to be published in this article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eIorio A, Stonebraker JS, Chambost H, et al. Establishing the prevalence and prevalence at birth of hemophilia in males: A meta-analytic approach using national registries. Ann Intern Med. 2019;171(8):540\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.7326/M19-1208\u003c/span\u003e\u003cspan address=\"10.7326/M19-1208\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRayment R, Chalmers E, Forsyth K, et al. Guidelines on the use of prophylactic factor replacement for children and adults with haemophilia A and B. Br J Haematol. 2020;190(5):684\u0026ndash;95. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/bjh.16704\u003c/span\u003e\u003cspan address=\"10.1111/bjh.16704\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodriguez-Merchan EC. 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National Data. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://data.stats.gov.cn\u003c/span\u003e\u003cspan address=\"https://data.stats.gov.cn\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed 11 March 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMedical Security Bureau of Fu Jian Provincial. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://ybj.fujian.gov.cn/\u003c/span\u003e\u003cspan address=\"https://ybj.fujian.gov.cn/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed July 1, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMedical Security Bureau of Yun Nan Provincial. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://ylbz.yn.gov.cn/\u003c/span\u003e\u003cspan address=\"https://ylbz.yn.gov.cn/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed July 1, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMedical Security Bureau of Guangxi Zhuang Autonomous Region. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://ybj.gxzf.gov.cn/\u003c/span\u003e\u003cspan address=\"http://ybj.gxzf.gov.cn/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed July 1, 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong X, Zhong J, Xue F, et al. An overview of patients with haemophilia A in China: Epidemiology, disease severity and treatment strategies. Haemophilia. 2021;27(1):e51\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/hae.14217\u003c/span\u003e\u003cspan address=\"10.1111/hae.14217\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePratap R, Misra M, Morampudi NV, Patil S, Reddy A. The existing scenario of haemophilia care in Canada and China \u0026ndash; A review. Hematol Transfus Cell Ther. 2020;42(4):356\u0026ndash;64. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.htct.2019.08.001\u003c/span\u003e\u003cspan address=\"10.1016/j.htct.2019.08.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOzelo MC, Matta MA, Yang R. Meeting the challenges of haemophilia care and patient support in China and Brazil. Haemoph 2012; 18;Suppl 5: 33\u0026ndash;810.1111/j.1365-2516.2012.02890.x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDong Zhaohui. ChenBinbin, Li Zhongqi.Medical Insurance and Management Analysis of Hemophilia\u0026mdash;Based on the Experience of Shenzhen. China Health Insurance 2018 No.112(01):32\u0026ndash;5.\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.19546/j.issn.1674-3830.2018.1.007.[Chinese]\u003c/span\u003e\u003cspan address=\"10.19546/j.issn.1674-3830.2018.1.007.[Chinese]\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe X, Wang X, Dong C, Zhao M, Wu J. The long-term clinical benefits and economic costs associated with increased use of prophylaxis among patients with haemophilia A in China: population-based predictions from 2018 to 2033. Haemophilia. 2022;28(5):726\u0026ndash;36. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/hae.14603\u003c/span\u003e\u003cspan address=\"10.1111/hae.14603\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThorat T, Neumann PJ, Chambers JD. Hemophilia burden of disease: A systematic review of the cost-utility literature for hemophilia. J Manag Care Spec Pharm. 2018;24(7):632\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.18553/jmcp.2018.24.7.632\u003c/span\u003e\u003cspan address=\"10.18553/jmcp.2018.24.7.632\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSrivastava A, Brewer AK, Mauser-Bunschoten EP, et al. Guidelines for the management of hemophilia. Haemophilia. 2013;19(1):e1\u0026ndash;47. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1365-2516.2012.02909.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2516.2012.02909.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTang L, Wu R, Sun J, et al. Short-term low-dose secondary prophylaxis for severe/moderate haemophilia A children is beneficial to reduce bleed and improve daily activity, but there are obstacle in its execution: a multi-centre pilot study in China. Haemophilia. 2013;19(1):27\u0026ndash;34. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1365-2516.2012\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2516.2012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 02926. x.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSun J, Zhou X, Hu N. Factor VIII replacement prophylaxis in patients with hemophilia A transitioning to adults: a systematic literature review. Orphanet J Rare Dis. 2021;16(1):287. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s13023-021-01919-w\u003c/span\u003e\u003cspan address=\"10.1186/s13023-021-01919-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2021 Jun 26.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1. Comparison between the data of hemophilia A in three provinces of south China and that in China\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"680\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameter\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEntire China\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFujian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGuangxi\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYunnan\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP1\u003c/strong\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP2\u003c/strong\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e5038（28.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e196（36.2%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e93（31.5%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e48（29.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eNo/unknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e12741(71.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e346（63.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e202 (68.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e114（70.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003edisease severity, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eMild \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1809（10.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e34\u0026nbsp;（6.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e14（4.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e12（7.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e0.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eModerat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e4788（26.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e397（73.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e67（22.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e73（45.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eSevere\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e6519（36.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e68\u0026nbsp;（12.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e90（30.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e69（42.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e4663（26.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e43（7.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e124（42.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e8（4.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDelayed diagnosis,n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1437（28.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e22（4.1%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e86（29.2%）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e39\u0026nbsp;（24.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e3560（71.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e392（72.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e91（30.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e123（75.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e128（23.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e118（40.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDelayed treatment,n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1750（39.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e8（1.5%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e51 （17.3%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e8 \u0026nbsp;（4.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e2714（60.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e217（40.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e126（42.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e148（91.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e317（58.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e118（40.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e6（3.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eJoint arthropathy, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1436（36%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e92\u0026nbsp;（17.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e119（40.4%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e110（67.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e2561（64%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e348（64.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e80\u0026nbsp;（27.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e52\u0026nbsp;（32.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e102（18.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e96（32.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTreatment strategy, n (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eProphylactic treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e425 （16.2%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e42(7.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e50 （16.9%） \u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e44（27.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e0.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eEpisodic treatments\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1162（44.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e160(29.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e122（41.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e63（38.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eOther\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e1033（39.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e33(6.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e26\u0026nbsp;（8.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e55（33.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e307(56.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e97（32,9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e0（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.205882352941178%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFactor VIII inhibitor\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"77.79411764705883%\" colspan=\"7\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003epositive\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e50\u0026nbsp;（9.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e31\u0026nbsp;（10.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e22 (13.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e260（48.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e122（41.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e108(66.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"22.173274596182086%\" valign=\"top\"\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.418502202643172%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e232（42.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.80323054331865%\" valign=\"top\"\u003e\n \u003cp\u003e142（48.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.95007342143906%\" valign=\"top\"\u003e\n \u003cp\u003e32(19.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.580029368575624%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.901615271659325%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.370044052863436%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003cstrong\u003eP1\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003emean\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eFujian vs \u0026nbsp;Entire China.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003cstrong\u003eP2\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eshow\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eGuangxi \u0026nbsp;vs \u0026nbsp;Entire China.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e***\u003c/strong\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003cstrong\u003e3 represent\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYunnan vs Entire China.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;The specific site of joint arthropathy in Guangxi, Fujian and Yunnan provinces\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"820\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.601466992665037%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eJoint\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.06845965770171%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft shoulder\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.845965770171149%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight shoulder\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.47921760391198%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft elbow\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.47921760391198%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight elbow\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.745721271393643%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft wrist\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.745721271393643%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight wrist\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.823960880195599%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft hip\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.43520782396088%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight hip\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.43520782396088%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft knee\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.43520782396088%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight knee\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.290953545232274%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeft ankle\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.613691931540343%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRight ankle\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.6095471236230114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGuangxi\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.854345165238678%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.833537331701346%\" valign=\"top\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.729498164014688%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.339449541284404%\" valign=\"top\"\u003e\n \u003cp\u003e(9.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(25.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(29.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(5.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.387942332896461%\" valign=\"top\"\u003e\n \u003cp\u003e(10.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e（9.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e（69.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e（72.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e(12.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.63040629095675%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e(20.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.6095471236230114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFujian\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.854345165238678%\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.833537331701346%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.729498164014688%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e(3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.339449541284404%\" valign=\"top\"\u003e\n \u003cp\u003e(5.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(38.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(2.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.387942332896461%\" valign=\"top\"\u003e\n \u003cp\u003e(20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e(20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e(28.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e(17.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e(4.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.63040629095675%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e(1.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"6.6095471236230114%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYunnan\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.854345165238678%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.487148102815177%\" valign=\"top\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.752753977968176%\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.833537331701346%\" valign=\"top\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.445532435740514%\" valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.078335373317014%\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.729498164014688%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e(2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.339449541284404%\" valign=\"top\"\u003e\n \u003cp\u003e(1.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(15.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.946264744429882%\" valign=\"top\"\u003e\n \u003cp\u003e(20.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.159895150720839%\" valign=\"top\"\u003e\n \u003cp\u003e(5.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.387942332896461%\" valign=\"top\"\u003e\n \u003cp\u003e(12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e(17.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e(58.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.043250327653997%\" valign=\"top\"\u003e\n \u003cp\u003e（56.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.650065530799475%\" valign=\"top\"\u003e\n \u003cp\u003e（20.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.63040629095675%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e（20.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e3. Prophylactic treatment in Guangxi, Fujian and Yunnan provinces\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"600\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eProphylactic treatments\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFujian\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=72)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGuangxi\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=69)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eYunnan\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(n=69)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP2\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e**\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDuration of prophylactic treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026le;3 months\u003c/p\u003e\n \u003cp\u003e3 to \u0026le;6 months\u003c/p\u003e\n \u003cp\u003e6 to \u0026le;12 months\u003c/p\u003e\n \u003cp\u003e12 to \u0026le;24 months\u003c/p\u003e\n \u003cp\u003e\u0026gt;24 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e5（6.9%）\u003c/p\u003e\n \u003cp\u003e5（6.9%)\u003c/p\u003e\n \u003cp\u003e10(13.9%)\u003c/p\u003e\n \u003cp\u003e11 (15.3%)\u003c/p\u003e\n \u003cp\u003e41 (57.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e1\u0026nbsp;（1.4%）\u003c/p\u003e\n \u003cp\u003e6\u0026nbsp;（8.7%）\u003c/p\u003e\n \u003cp\u003e18（26.1%）\u003c/p\u003e\n \u003cp\u003e11（16.0%）\u003c/p\u003e\n \u003cp\u003e33（47.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e1\u0026nbsp;（1.4%）\u003c/p\u003e\n \u003cp\u003e4\u0026nbsp;（5.7%）\u003c/p\u003e\n \u003cp\u003e8\u0026nbsp;（11.6%）\u003c/p\u003e\n \u003cp\u003e16（23.2%）\u003c/p\u003e\n \u003cp\u003e40（58.0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e0.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of prophylactic treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e1 time/week\u003c/p\u003e\n \u003cp\u003e2\u0026ndash;3 times/week\u003c/p\u003e\n \u003cp\u003e\u0026gt;3 times/week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e14（19.5%）\u003c/p\u003e\n \u003cp\u003e53（73.6%）\u003c/p\u003e\n \u003cp\u003e5 \u0026nbsp;（6.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e19（27.5%）\u003c/p\u003e\n \u003cp\u003e49（71.1%）\u003c/p\u003e\n \u003cp\u003e1\u0026nbsp;（1.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e11（16.0%）\u003c/p\u003e\n \u003cp\u003e58（84.0%）\u003c/p\u003e\n \u003cp\u003e0 \u0026nbsp;（0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDose of prophylactic treatment\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30%\" valign=\"top\"\u003e\n \u003cp\u003e10u/kg\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e10-15 u/kg \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e15-20 u/kg \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e＞20 u/kg \u0026nbsp;\u003c/p\u003e\n \u003cp\u003eunknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e8 \u0026nbsp;（11.1%）\u003c/p\u003e\n \u003cp\u003e15（20.8%）\u003c/p\u003e\n \u003cp\u003e28（38.9%）\u003c/p\u003e\n \u003cp\u003e11（15.3%）\u003c/p\u003e\n \u003cp\u003e10（13.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e16 (23.2%)\u003c/p\u003e\n \u003cp\u003e14 (20.3%)\u003c/p\u003e\n \u003cp\u003e24（34.8%）\u003c/p\u003e\n \u003cp\u003e15（21.7%）\u003c/p\u003e\n \u003cp\u003e0 \u0026nbsp; （0%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e13 (18.9%)\u003c/p\u003e\n \u003cp\u003e14 (20.3%)\u003c/p\u003e\n \u003cp\u003e25（36.2%）\u003c/p\u003e\n \u003cp\u003e17（24.6%）\u003c/p\u003e\n \u003cp\u003e0 \u0026nbsp; （0%）\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9%\" valign=\"top\"\u003e\n \u003cp\u003e0.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.5%\" valign=\"top\"\u003e\n \u003cp\u003e0.53\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003cem\u003eP\u003c/em\u003e1 show\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eGuangxi\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003evs\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Fujian\u003c/strong\u003e\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e**\u003cem\u003eP2\u003c/em\u003e mean\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eGuangxi\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;vs\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYunnan\u003c/strong\u003e\u003cstrong\u003e.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Questionnaire survey on diagnosis and treatment of hemophiliac in Guangxi\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"553\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eHemophilia A+B（N=170）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eHemophilia A\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e144 (84.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eHemophilia B\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e26（15.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eType of hospital where the patient was diagnosed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eGrade-A Secondary hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e7（4.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eGrade-B Secondary hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e1（0.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eGrade-A Tertiary hospital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e132（77.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNot clear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e30（17.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eCan coagulation factors be obtained at local hospitals？\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e112（65.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e58（34.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eSupply status of clotting factors in hospitals at ordinary times\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eAdequate supply\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e16（9.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eOften in short supply\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e33（19.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eOccasionally, in short supply\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e121（71.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eProphylactic treatment status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;I don\u0026rsquo;t know what prophylactic treatment is\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e35（20.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNever received prophylactic treatment.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e10（5.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eOccasional prophylactic treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e58（34.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eLong-term prophylactic treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e67（39.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eAnnual testing for the presence of inhibitors\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNever been tested\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e63（37.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNo, a test is taken if the doctor advises doing so.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e65（38.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eYes, it is tested every year.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e42（24.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eDo you know the method of injecting on your own/child？\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e69（40.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eI did, but I was afraid to inject\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e80（47.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eYes, I often inject myself/my children.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e21（12.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eWill the clotting factor be used immediately when there is bleeding?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eDo not use it when there is less bleeding; use it only when the bleeding does not stop.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e30（17.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eDepending on the clotting factor reserve, use it when the reserve is sufficient.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e19（11.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eUse clotting factor immediately\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e121（71.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eDo you go to the hemophilia center for your usual treatment？\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNo\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e114（61.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e56（32.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eDo you record your clotting factor use？\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNo record of it\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e54（31.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eRecord occasionally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e37（21.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eFrequently record\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e34（20%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eRecord every time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e45（26.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eIs it easy to find hemophilia professionals when seeing a doctor in Guangxi?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eEasy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e64（37.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNot easy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e106（62.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eMonthly expenses for payment of clotting factors (after reimbursement of medical insurance)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Valid data（3374.55 \u0026plusmn; 393.516 yuan）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e149（87.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Not calculated or not clear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e21（12.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eMonthly household income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;More than 20,000 yuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e2（1.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;10,000\u0026ndash;20,000 yuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e4（2.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;5,000\u0026ndash;10,000 yuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e21（12.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; 3,000\u0026ndash;5,000 yuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e66（38.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eLess than 3,000 yuan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e77（45.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eEmployment/academic status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eWorking/studying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e114（67.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Unemployed/out of school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e56（32.9%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eTypes of medical insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Medical insurance for urban employees\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e11（6.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eUrban employee medical insurance + commercial insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e2（1.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eNew rural cooperative medical insurance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e157（92.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eSources of information on hemophilia (choose three items)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Rarely pay attention to this knowledge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e3（1.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Expert lectures at hemophilia exchange meetings\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e99（58.2%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; The doctor and nurse inform\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e71（41.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Books/newspapers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e40（23.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; WeChat Official Account\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e70（41.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eHemophiliac group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e154（90.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eWhat kind of help do you want doctors and nurses to provide? (Multiple selections)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Build a communication platform to establish close contact\u003c/p\u003e\n \u003cp\u003ewith other patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e75（44.1%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Teach me how to inject clotting factor by myself to improve the success rate of injection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e86（50.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Teach me some simple rehabilitation exercises so that I can exercise by myself\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Encouraged by doctors and nurses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e122（71.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Carry out onsite injection service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Provide frontier knowledge of hemophilia treatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e61（35.8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eInstruct me to calculate the dosage of a clotting factor according to the bleeding status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e59（34.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Others\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e96（56.5%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eWhat are your expectations for the future treatment of hemophilia (fill in the blank)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eBlank\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e21（12.4%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Increase in medical insurance quota and reimbursement ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e65（43.6%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; Sufficient drug supply in county-level hospitals\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e12（8%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"75.04520795660036%\" valign=\"top\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.95479204339964%\" valign=\"top\"\u003e\n \u003cp\u003e51（34%）_\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"hemophilia, economical development, delayed diagnosis, prophylactic treatments, joint deformity","lastPublishedDoi":"10.21203/rs.3.rs-4015158/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4015158/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: To investigatethe management status of hemophilia A patients in Fujian, Guangxi and Yunnan provinces in South China and their gaps with the national data. To explore which plays a more important role in hemophilia treatment, economical development or medical technology?\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: The data of hemophilia A patients registered in Fujian, Guangxi and Yunnan provinces were analyzed, and their diagnosis and treatment were studied and compared with the published national data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: 542 hemophilia A cases were registered in Fujian, including mild ones 6.3%, moderate 73.2%, severe 12.6% and unknown 7.9%; 295 cases in Guangxi, mild 4.7%, moderate 22.7%, severe 30.5% and unknown 42.1%; 162 cases in Yunnan, mild 7.4%, moderate 45.1%, severe 42.6% and unknown 4.9%. The proportion of patients with severe hemophilia A in Fujian was significantly lower than that in Guangxi, Yunnan and national data (\u003cem\u003eP \u003c/em\u003e\u0026lt; 0.05). Approximately29.2% had a delayed diagnosis in Guangxi (24.1% in Yunnan, 4.1% in Fujian, national data: 28.8%; \u003cem\u003eP\u003c/em\u003e=0.000). The rate of delayed treatment is 17.3% in Guangxi, 4.9% in Yunnan,1.5% in Fujian and 39.2% in national data. The rate of joint deformity is 67.9% in Yunnan, 40.4% in Guangxi, 36% in national data and 17.0% in Fujian. The prophylactic treatmentrates in Guangxi and Yunnan were 16.9% and 27.2% respectively, which were statistically significant compared with the national rate (16.2%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Diagnosis and treatment status of hemophilia A in the three southern provinces of China are significantly different from the national data. In hemophilia treatment, economical development plays a more important role.At similar economic levels, medical technology will cause a gap in the level of hemophilia treatment.\u003c/p\u003e","manuscriptTitle":"Which plays a more important role in hemophilia treatment, economical development or medical technology?","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-10 06:34:37","doi":"10.21203/rs.3.rs-4015158/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1f0c4a75-5307-4430-8859-56894241a7cd","owner":[],"postedDate":"June 10th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-28T16:32:16+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-10 06:34:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4015158","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4015158","identity":"rs-4015158","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}