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Jin L, He F, Zhang C. Quality management of the newborn screening network: the Chinese experience. Chin Med J (Engl) 2023; 136:2122-2124. [PMID: 36921115 PMCID: PMC10476775 DOI: 10.1097/cm9.0000000000002386] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Indexed: 03/17/2023] Open
Affiliation(s)
- Lizi Jin
- Department of Biochemistry, National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing 100730, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Falin He
- Department of External Quality Assessment, National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing 100730, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Chuanbao Zhang
- Department of Biochemistry, National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing 100730, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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2
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Giugliani R, Castillo Taucher S, Hafez S, Oliveira JB, Rico-Restrepo M, Rozenfeld P, Zarante I, Gonzaga-Jauregui C. Opportunities and challenges for newborn screening and early diagnosis of rare diseases in Latin America. Front Genet 2022; 13:1053559. [PMID: 36568372 PMCID: PMC9773081 DOI: 10.3389/fgene.2022.1053559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Rare diseases (RDs) cause considerable death and disability in Latin America. Still, there is no consensus on their definition across the region. Patients with RDs face a diagnostic odyssey to find a correct diagnosis, which may last many years and creates a burden for caregivers, healthcare systems, and society. These diagnostic delays have repercussions on the health and economic burden created by RDs and continue to represent an unmet medical need. This review analyzes barriers to the widespread adoption of newborn screening (NBS) programs and early diagnostic methods for RDs in Latin America and provides recommendations to achieve this critical objective. Increasing the adoption of NBS programs and promoting early diagnosis of RDs are the first steps to improving health outcomes for patients living with RDs. A coordinated, multistakeholder effort from leaders of patient organizations, government, industry, medical societies, academia, and healthcare services is required to increase the adoption of NBS programs. Patients' best interests should remain the guiding principle for decisions regarding NBS implementation and early diagnosis for RDs.
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Affiliation(s)
- Roberto Giugliani
- Department of Genetics UFRGS, Medical Genetics Service HCPA, DASA and Casa dos Raros, Porto Alegre, Brazil,*Correspondence: Roberto Giugliani, ; Claudia Gonzaga-Jauregui,
| | - Silvia Castillo Taucher
- Clinical Geneticist, Hospital Clínico Universidad de Chile, Clínica Alemana de Santiago, Santiago, Chile
| | | | - Joao Bosco Oliveira
- Laboratório de Genética Molecular, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
| | | | - Paula Rozenfeld
- Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, asociado CIC PBA, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, La Plata, Argentina
| | - Ignacio Zarante
- Instituto de Genética Humana, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Claudia Gonzaga-Jauregui
- International Laboratory for Human Genome Research, Laboratorio Internacional de Investigación sobre el Genoma Humano, Universidad Nacional Autónoma de México, Juriquilla, México,*Correspondence: Roberto Giugliani, ; Claudia Gonzaga-Jauregui,
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3
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Yu CW, He XY, Wan KX, Yuan ZJ, Liu H, Zhang J, Liu S, Yang J, Zou L. Improving quality management of newborn screening in southwest China. J Int Med Res 2021; 49:3000605211002999. [PMID: 33823629 PMCID: PMC8033469 DOI: 10.1177/03000605211002999] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective Newborn screening (NBS) programs benefit tens of millions of infants
worldwide each year. However, the extremely large screening populations and
number of laboratories involved pose great challenges to maintaining high
screening quality. To achieve continuous quality improvement, we established
a comprehensive quality management system (CQMS) in southwest China. Methods External quality assessment (EQA) and internal quality control were carried
out for basic quality management. We used 16 quality indicators (QIs) to
monitor the entire screening process, with external supervision from the
China National Accreditation Service for Conformity Assessment. All
retrospective data for quality assessment were collected consecutively from
laboratory management and patient follow-up systems. Results From 2015 to 2019, satisfactory EQA performance was achieved, with an average
score greater than 97 for each screening item. QI monitoring showed that NBS
quality improved continuously. The rate of health education provision
increased from 90.9% to 100% and the recall rate after a positive primary
screening increased from 85.4% to 99.2%. The unsatisfactory specimen rate
and rate of newborns lost to follow-up decreased to 0.38% and 0.08%,
respectively. Conclusions Implementing a CQMS and monitoring the whole screening process using QIs may
yield continuous quality improvement of NBS.
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Affiliation(s)
- Chao-Wen Yu
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiao-Yan He
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ke-Xing Wan
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Zhao-Jian Yuan
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hao Liu
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Juan Zhang
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Shan Liu
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Jing Yang
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Lin Zou
- Center for Clinical Molecular Medicine & Newborn Screening, Children's Hospital of Chongqing Medical University; National Clinical Research Center for Child Health and Disorders; Ministry of Education Key Laboratory of Child Development and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing, China
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4
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Ascurra M, Alvarez P, Ortíz-Paranza L, Blanco F, Valenzuela A, Insaurralde A, Rodríguez S, Salinas M, Porzio G, Núñez A. Consolidation of the Neonatal Screening Program as a Public Health Program in Paraguay. JOURNAL OF INBORN ERRORS OF METABOLISM AND SCREENING 2021. [DOI: 10.1590/2326-4594-jiems-2021-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Marta Ascurra
- Ministerio de Salud Pública y Bienestar Social, Paraguay
| | - Pamela Alvarez
- Ministerio de Salud Pública y Bienestar Social, Paraguay
| | | | - Fabiola Blanco
- Ministerio de Salud Pública y Bienestar Social, Paraguay
| | | | | | | | - Mirna Salinas
- Ministerio de Salud Pública y Bienestar Social, Paraguay
| | | | - Andrea Núñez
- Ministerio de Salud Pública y Bienestar Social, Paraguay
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5
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Philippine Performance Evaluation and Assessment Scheme (PPEAS): Experiences in Newborn Screening System Quality Improvement. Int J Neonatal Screen 2020; 6:ijns6040095. [PMID: 33322257 PMCID: PMC7780925 DOI: 10.3390/ijns6040095] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 11/16/2022] Open
Abstract
Newborn Bloodspot Screening (NBS) has existed for over 60 years, having been initiated by Guthrie in the U.S. In the Philippines, NBS was introduced in 1996 and later was supported by legislation. The NBS program now includes 29 conditions, covering 91.6% of the newborn population in 2019. Program growth and expansion necessitated development of a formal performance evaluation and assessment scheme (PEAS) for monitoring performance and for continuously improving quality. This study's objective was to present the development, implementation, and results to date of the Philippine Performance PEAS (PPEAS). Using the comprehensive listing of laboratory and non-laboratory elements in the model PEAS system in the U.S., PPEAS tools were developed for critical Philippine NBS system components: regional Department of Health (national health agency, Philippines) (DOH) offices (CHDs), NBS laboratories (NSCs), NBS specimen submitters (NSFs), and long-term case management centers (NBSCCs). Data generated from the various PPEAS have been periodically reviewed and analyzed for NBS system impact. PPEAS were developed to facilitate quality improvement at various levels of the Philippine NBS system. PPEAS identified successes, gaps, and challenges to be addressed by NSCs, NSFs, CHDs, and NBSCCs with the assistance of the Newborn Screening Reference Center and the Department of Health.
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Therrell BL, Lloyd-Puryear MA, Ohene-Frempong K, Ware RE, Padilla CD, Ambrose EE, Barkat A, Ghazal H, Kiyaga C, Mvalo T, Nnodu O, Ouldim K, Rahimy MC, Santos B, Tshilolo L, Yusuf C, Zarbalian G, Watson MS. Empowering newborn screening programs in African countries through establishment of an international collaborative effort. J Community Genet 2020; 11:253-268. [PMID: 32415570 PMCID: PMC7295888 DOI: 10.1007/s12687-020-00463-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/02/2020] [Indexed: 02/02/2023] Open
Abstract
In an effort to explore new knowledge and to develop meaningful collaborations for improving child health, the First Pan African Workshop on Newborn Screening was convened in June 2019 in Rabat, Morocco. Participants included an informal network of newborn screening stakeholders from across Africa and global experts in newborn screening and sickle cell disease. Over 150 attendees, representing 20 countries, were present including 11 African countries. The agenda focused on newborn screening rationale, techniques, system development, implementation barriers, ongoing research, and collaborations both globally and across Africa. We provide an overview of the workshop and a description of the newborn screening activities in the 11 African countries represented at the workshop, with a focus on sickle cell disease.
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Affiliation(s)
- Bradford L Therrell
- National Newborn Screening and Global Resource Center, University of Texas Health Science Center at San Antonio, Austin, TX, USA.
| | | | - Kwaku Ohene-Frempong
- Sickle Cell Foundation of Ghana, National Newborn Screening Program for Sickle Cell Disease, Accra, Ghana
| | - Russell E Ware
- Division of Hematology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Emmanuela E Ambrose
- Bugando Medical Centre and Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Amina Barkat
- Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
| | - Hassan Ghazal
- National Center for Scientific and Technological Research, Rabat, Morocco
| | - Charles Kiyaga
- Central Public Health Laboratories, Ministry of Health, Kampala, Uganda
| | - Tisungane Mvalo
- University of North Carolina Project Malawi, Lilongwe, Malawi
| | - Obiageli Nnodu
- Centre of Excellence for Sickle Cell Disease Research and Training, University of Abuja, Abuja, Nigeria
| | - Karim Ouldim
- Faculty of Medicine and Pharmacy, University Sidi Mohamed Ben Abdellah, Fes, Morocco
| | - Mohamed Chérif Rahimy
- National Sickle Cell Disease Center, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Brígida Santos
- Centro de Apoio ao Doente Anémico, Hospital Pediátrico David Bernardino, Luanda, Angola
| | - Léon Tshilolo
- Centre Hospitalier Monkole, Kinshasa, Democratic Republic of the Congo
| | - Careema Yusuf
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Guisou Zarbalian
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Michael S Watson
- American College of Medical Genetics and Genomics, Bethesda, MD, USA
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7
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Viall S, Calhoun A, Mew NA, Tarini BA. How a baby with classic galactosemia was nearly missed: When the test succeeds but system fails. Am J Med Genet A 2020; 182:1750-1753. [PMID: 32275121 DOI: 10.1002/ajmg.a.61587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/06/2020] [Accepted: 03/25/2020] [Indexed: 11/07/2022]
Abstract
Newborn screening (NBS) is a well-established state-run public health program which has targeted the early identification of treatable diseases like classic galactosemia (CG) for over a decade. We describe the case of a symptomatic newborn with CG and an abnormal screen report, including positive DNA-based test, who still managed to fall through the cracks in a sub-optimally functioning NBS program, despite decades of screening experience. While much attention is paid to testing technology, this case illustrates basic minimum requirements a newborn screening program must fulfill to reliably identify and treat all affected individuals including minimum reporting requirements, case surveillance and a dedicated short-term follow-up program. In newborn screening, success is systematic.
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Affiliation(s)
- Sarah Viall
- Rare Disease Institute, Children's National Hospital, Washington, District of Columbia, USA
| | - Amy Calhoun
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Nicholas Ah Mew
- Rare Disease Institute, Children's National Hospital, Washington, District of Columbia, USA
| | - Beth A Tarini
- Center for Translational Research, Children's National Research Institute, Children's National Medical Center, Washington, District of Columbia, USA
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8
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Kingsmore SF, Ramchandar N, James K, Niemi AK, Feigenbaum A, Ding Y, Benson W, Hobbs C, Nahas S, Chowdhury S, Dimmock D. Mortality in a neonate with molybdenum cofactor deficiency illustrates the need for a comprehensive rapid precision medicine system. Cold Spring Harb Mol Case Stud 2020; 6:a004705. [PMID: 32014857 PMCID: PMC6996516 DOI: 10.1101/mcs.a004705] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/30/2019] [Indexed: 12/31/2022] Open
Abstract
Neonatal encephalopathy with seizures is a presentation in which rapid whole-genome sequencing (rWGS) has shown clinical utility and improved outcomes. We report a neonate who presented on the third day of life with seizures refractory to antiepileptic medications and neurologic and computerized tomographic findings consistent with severe generalized brain swelling. rWGS revealed compound heterozygous variants in the molybdenum cofactor synthesis gene, type 1A (MOCS1 c.*7 + 5G > A and c.377G > A); a provisional diagnosis of molybdenum cofactor deficiency on day of life 4. An emergency investigational new drug application for intravenous replacement of the MOCS1 product, cyclic pyranopterin monophosphate, was considered, but felt unsuitable in light of the severity of disease and delay in the start of treatment. The patient died on day of life 9 despite having a precise molecular diagnosis within the first week of life. This case illustrates that an rWGS-based molecular diagnosis within the first week of life may be insufficient to improve outcomes. However, it did inform clinical decision-making with regard to resuscitation and predicted long-term outcome. We suggest that to achieve optimal reductions in morbidity and mortality, rWGS must be implemented within a comprehensive rapid precision medicine system (CRPM). Akin to newborn screening (NBS), CRPM will have onboarding, diagnosis, and precision medicine implementation components developed in response to patient and parental needs. Education of health-care providers in a learning model in which ongoing data analyses informs system improvement will be essential for optimal effectiveness of CRPM.
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Affiliation(s)
- Stephen F Kingsmore
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Nanda Ramchandar
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
- Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, California 92123, USA
| | - Kiely James
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Anna-Kaisa Niemi
- Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, California 92123, USA
| | - Annette Feigenbaum
- Department of Pediatrics, Rady Children's Hospital, University of California, San Diego, California 92123, USA
| | - Yan Ding
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Wendy Benson
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Charlotte Hobbs
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Shareef Nahas
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - Shimul Chowdhury
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
| | - David Dimmock
- Rady Children's Institute for Genomic Medicine, San Diego, California 92123, USA
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Analyzing Patterns in NewSTEPs Site Review Recommendations: Practical Applications for Newborn Screening Programs. Int J Neonatal Screen 2019; 5:13. [PMID: 33072973 PMCID: PMC7510203 DOI: 10.3390/ijns5010013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 02/02/2019] [Indexed: 11/17/2022] Open
Abstract
The Newborn Screening Technical assistance and Evaluation Program (NewSTEPs) conducts non-regulatory site reviews of state newborn screening programs in the US with the goal of providing comprehensive reports and recommendations to support quality improvements within the system. A detailed coding and qualitative analysis of data extracted from reports of seven programs visited between 2012 and 2017, of thirteen pre-site visit surveys completed by state newborn screening programs, and of information from interviews conducted with three site review experts revealed four common themes that exist across states within the national newborn screening system. These themes include opportunities to implement improvements in: (1) communications inside and outside of the state newborn screening program, (2) education, (3) information technology, and (4) operations. The cross-cutting recommendations provided by NewSTEPs within the comprehensive site review reports may prove valuable for all state programs to consider and to incorporate as quality improvement measures in the absence of a full site review. The analysis of the site review process and recommendations identified important opportunities for improvement, many of which were previously unknown to be common across programs, and also provided affirmation of known challenges.
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Abstract
PURPOSE OF REVIEW We review newborn screening (NBS) publications from the developing countries to identify global progress in improving child health. RECENT FINDINGS Many developing countries do not yet have national NBS. As infant mortality rates decline, NBS gains in public health priority. Local incidence and outcome data are used to persuade health officials to include screening in priority health spending. Congenital hypothyroidism is the most cost-effective screened condition in most countries. In sub-Saharan Africa, India and some parts of Asia, screening for hemoglobinopathies and glucose-6-dehydrogenase deficiency are also important. Expanded screening for metabolic conditions is most needed in areas of high consanguinity. Screening for hearing disorders and critical congenital heart defects is increasing globally. The largest birth cohorts are India and China, but only China has successful NBS. Reports from completed government research projects in India support initiation of NBS. SUMMARY Government activities around NBS are increasing in India and there is increased emphasis on pilot programs for sickle cell NBS in sub-Saharan Africa. Genetic counseling training in Asia and Africa is increasing and will be helpful as part of NBS. To build successful screening programs, partnerships among health professionals, parents, policy makers and industry stakeholders are essential.
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11
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Ayatollahi H, Karimi S, Ahmadi M. Newborn screening data management: proposing a framework for Iran. BMJ Health Care Inform 2018; 25:221-229. [PMID: 30672403 DOI: 10.14236/jhi.v25i4.985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 07/02/2018] [Accepted: 09/21/2018] [Indexed: 11/18/2022] Open
Abstract
IntroductionDifferent countries use a variety of methods to manage the newborn screening data. In this study, we aimed to compare the experiences of the selected countries to propose a framework for managing the newborn screening data in Iran.MethodsIn this comparative study, data were collected using electronic databases and the official website of the Department of Health in America, England and Australia. Data related to the process of newborn screening in Iran were collected using an open-ended questionnaire and reviewing the published documents.ResultsIn this study, a framework for newborn screening data management was proposed which consisted of six main areas, namely; objectives, involved organisations, data elements, data collection processes, data classification systems and the methods of controlling data quality.ConclusionThe framework suggested in this study can help to re-organise the process of newborn screening with more focus on data management. These data can be used in conducting research and setting strategies for improving the quality of child health in the country.
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Ojodu J, Singh S, Kellar-Guenther Y, Yusuf C, Jones E, Wood T, Baker M, Sontag MK. NewSTEPs: The Establishment of a National Newborn Screening Technical Assistance Resource Center. Int J Neonatal Screen 2018; 4:1. [PMID: 33072927 PMCID: PMC7510199 DOI: 10.3390/ijns4010001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 12/15/2017] [Indexed: 12/03/2022] Open
Abstract
As newborn screening (NBS) programs in the US implement expanded screening panels, utilize emerging technologies and identify areas for improvement, the need to establish and maintain a community engagement based national technical assistance center becomes apparent. The Newborn Screening Technical assistance and Evaluation Program (NewSTEPs)-a program of the Association of Public Health Laboratories (APHL) in partnership with the Colorado School of Public Health (ColoradoSPH), offers expertise in newborn screening program development, member connection, data analysis, and program evaluation. NewSTEPs provides a secure online data repository designed to collect comprehensive data on newborn screening programs in three strata: state profiles (description of each state program including program hours, fees, and disorders screened), quality indicators (metrics of program performance encompassing screening accuracy and timeliness) and NBS public health surveillance case definitions. NewSTEPs was created in 2012 under a cooperative agreement with the United States Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Successful activities of NewSTEPs have resulted in the establishment of a technical assistance resource center and the organization of a network of newborn screening experts. In addition, NewSTEPs coordinates efforts with other federally funded programs in order to maximize resources and to ensure a unified approach to data collection and information sharing.
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Affiliation(s)
- Jelili Ojodu
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
- Correspondence: ; Tel.: +1-240-485-2772
| | - Sikha Singh
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
| | - Yvonne Kellar-Guenther
- Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Careema Yusuf
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
| | - Elizabeth Jones
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
| | - Thalia Wood
- Association of Public Health Laboratories, 8515 Georgia Avenue, Suite 700, Silver Spring, MD 20910, USA
| | - Mei Baker
- Wisconsin State Laboratory of Hygiene and Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI 53706, USA
| | - Marci K. Sontag
- Colorado School of Public Health, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO 80045, USA
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13
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Alfadhel M, Al Othaim A, Al Saif S, Al Mutairi F, Alsayed M, Rahbeeni Z, Alzaidan H, Alowain M, Al-Hassnan Z, Saeedi M, Aljohery S, Alasmari A, Faqeih E, Alwakeel M, AlMashary M, Almohameed S, Alzahrani M, Migdad A, Al-Dirbashi OY, Rashed M, Alamoudi M, Jacob M, Alahaidib L, El-Badaoui F, Saadallah A, Alsulaiman A, Eyaid W, Al-Odaib A. Expanded Newborn Screening Program in Saudi Arabia: Incidence of screened disorders. J Paediatr Child Health 2017; 53:585-591. [PMID: 28337809 DOI: 10.1111/jpc.13469] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/01/2016] [Accepted: 11/13/2016] [Indexed: 11/29/2022]
Abstract
AIM To address the implementation of the National Newborn Screening Program (NBS) in Saudi Arabia and stratify the incidence of the screened disorders. METHODS A retrospective study conducted between 1 August 2005 and 31 December 2012, total of 775 000 newborns were screened from 139 hospitals distributed among all regions of Saudi Arabia. The NBS Program screens for 16 disorders from a selective list of inborn errors of metabolism (IEM) and endocrine disorders. Heel prick dry blood spot samples were obtained from all newborns for biochemical and immunoassay testing. Recall screening testing was performed for Initial positive results and confirmed by specific biochemical assays. RESULTS A total of 743 cases were identified giving an overall incidence of 1:1043. Frequently detected disorders nationwide were congenital hypothyroidism and congenital adrenal hyperplasia with an incidence of 1:7175 and 1:7908 correspondingly. The highest incidence among the IEM was propionic acidaemia with an incidence rate of 1:14 000. CONCLUSION The article highlights the experience of the NBS Program in Saudi Arabia and providing data on specific regional incidences of all the screened disorders included in the programme; and showed that the incidence of these disorders is one of the highest reported so far world-wide.
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Affiliation(s)
- Majid Alfadhel
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Ali Al Othaim
- King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Pathology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saif Al Saif
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Fuad Al Mutairi
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Moeenaldeen Alsayed
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zuhair Rahbeeni
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hamad Alzaidan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammed Alowain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zuhair Al-Hassnan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,The National Newborn Screening Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohamad Saeedi
- Noncommunicable Disease, Ministry of Health, Riyadh, Saudi Arabia
| | - Saeed Aljohery
- Noncommunicable Disease, Ministry of Health, Riyadh, Saudi Arabia
| | - Ali Alasmari
- Medical Genetic Section, King Fahad Medical City, Children's Hospital, Riyadh, Saudi Arabia
| | - Eissa Faqeih
- Medical Genetic Section, King Fahad Medical City, Children's Hospital, Riyadh, Saudi Arabia
| | | | - Maher AlMashary
- Armed Forces Medical Services Directorate, Riyadh, Saudi Arabia
| | | | - Mohammed Alzahrani
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abeer Migdad
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Osama Y Al-Dirbashi
- Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE.,Children Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | | | | | - Minnie Jacob
- Research Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | | | - Amal Saadallah
- Research Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Wafaa Eyaid
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Ali Al-Odaib
- Research Center, Ministry of Health, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia
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Minkovitz CS, Grason H, Ruderman M, Casella JF. Newborn Screening Programs and Sickle Cell Disease: A Public Health Services and Systems Approach. Am J Prev Med 2016; 51:S39-47. [PMID: 27320464 PMCID: PMC4916337 DOI: 10.1016/j.amepre.2016.02.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 02/01/2016] [Accepted: 02/18/2016] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Despite universal newborn screening (NBS), children in the U.S. continue to experience morbidity and mortality from sickle cell disease and related causes. Recognizing that assessments of public health services and systems can improve public health system performance and ultimately health outcomes, this study examined variations in NBS program activities for sickle cell disease. METHODS A mixed methods study included (1) a 2009 survey of NBS programs based on ten essential public health services (N=39 states with ten or more sickle cell births over a 3-year period) and (2) key informant interviews in 2011 with 13 states that had sufficient Phase 1 survey scores, black births, and variability in state legislation and geography. Key informants were from 13 NBS programs, 22 sickle cell treatment centers, and ten advocacy organizations. Analyses were conducted in 2009-2014. RESULTS Considerable variability exists across states in program activities and roles. More programs reported activities oriented to care of individuals-ensuring access to services, coordination, and provider education; fewer reported planning and analysis activities oriented to statewide policy development and system change. Numbers of activities were not related to the number of affected births. In-depth interviews identified opportunities to enhance activities that support statewide comprehensive systems of care. CONCLUSIONS NBS programs perform important public health roles that complement and enhance clinical services. Nationwide efforts are needed to enable NBS programs to strengthen population-based functions that are essential to ensuring quality of care for the entire population of children and families affected by sickle cell disease.
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Affiliation(s)
- Cynthia S Minkovitz
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
| | - Holly Grason
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Marjory Ruderman
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - James F Casella
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
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15
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Abstract
The development of a T-cell receptor excision circle (TREC) assay utilizing dried blood spots in universal newborn screening has allowed the early detection of T-cell lymphopenia in newborns. Diagnosis of severe combined immunodeficiency (SCID) in affected infants in the neonatal period, while asymptomatic, permits early treatment and restoration of a functional immune system. SCID was the first immunodeficiency disease to be added to the Recommended Uniform Screening Panel of Core Conditions in the United States in 2010, and it is now implemented in 26 states in the U.S. This review covers the development of newborn screening for SCID, the biology of the TREC test, its current implementation in the U.S., new findings for SCID in the newborn screening era, and future directions.
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16
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Italia Y, Krishnamurti L, Mehta V, Raicha B, Italia K, Mehta P, Ghosh K, Colah R. Feasibility of a newborn screening and follow-up programme for sickle cell disease among South Gujarat (India) tribal populations. J Med Screen 2014; 22:1-7. [PMID: 25341880 DOI: 10.1177/0969141314557372] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the feasibility of a newborn screening and follow-up programme for sickle cell disease (SCD) among tribal populations of south Gujarat, India. METHODS A total of 5467 newborn babies were screened over 2 years using High-performance liquid chromatography, with diagnosis by molecular analysis. The SCD babies were followed-up clinically and haematologically regularly for 1.5 to 5 years to describe the course of the disease. RESULTS Thirty-three babies (0.60%) were sickle homozygous, 13 (0.23%) were-sickle-β-thalassaemia, 687 (12.5%) were sickle heterozygous, and 4736 were unaffected. The parents of SCD babies were educated and counselled for home care. There were 32 babies (69.5%) who could be clinically and haematologically followed-up; 7 babies (21.8%) presented with severe clinical complications, whereas 18 (56.2%) babies were asymptomatic till the last follow-up. The variation in clinical presentation was seen in spite of the presence of ameliorating factors, such as high fetal haemoglobin, Xmn-I polymorphism, and α-thalassaemia. CONCLUSION In addition to demonstrating the possibility of establishing a newborn screening programme for sickle cell disorders among tribal populations, this study has shown that the disease is not always mild among tribal groups in India, as previously believed. There is a need, therefore, for increasing awareness among these tribal groups about the disease, and for regular monitoring of affected babies to reduce morbidity and mortality and to understand the natural course of the disease.
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Affiliation(s)
| | - Lakshmanan Krishnamurti
- Children's Hospital of Pittsburgh of UPMC, 4401 Penn Ave, Pittsburgh, PA 15224, United States
| | | | | | - Khushnooma Italia
- National Institute of Immunohaematology, 13 Floor, K.E.M. Hospital Campus, Parel, Mumbai 400 012, India
| | - Pallavi Mehta
- National Institute of Immunohaematology, 13 Floor, K.E.M. Hospital Campus, Parel, Mumbai 400 012, India
| | - Kanjaksha Ghosh
- National Institute of Immunohaematology, 13 Floor, K.E.M. Hospital Campus, Parel, Mumbai 400 012, India
| | - Roshan Colah
- National Institute of Immunohaematology, 13 Floor, K.E.M. Hospital Campus, Parel, Mumbai 400 012, India
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Spector LG, Murphy SE, Wickham KM, Lindgren B, Joseph AM. Prenatal tobacco exposure and cotinine in newborn dried blood spots. Pediatrics 2014; 133:e1632-8. [PMID: 24819573 PMCID: PMC4035592 DOI: 10.1542/peds.2013-3118] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Tobacco smoking by pregnant women is a major public health hazard with both short- and long-term effects on offspring. This study describes the presence and level of the nicotine metabolite cotinine in newborn dried blood spots (DBS) and compares it with the reported maternal smoking recorded on state birth registries. We hypothesize that cotinine in DBS may be a useful measure of newborn in utero tobacco exposure. METHODS An observational, cross-sectional study of 1414 DBS obtained from California, Michigan, New York, and Washington newborn screening programs was carried out. Cotinine levels in DBS were quantified by liquid chromatography tandem mass spectrometry analysis and compared with maternal smoking as reported in vital statistics data. RESULTS Cotinine ≥0.3 ng/g was detected in 35% of newborn DBS, including DBS of 29% of newborns whose mothers reportedly did not smoke cigarettes during pregnancy, some of whom were presumably exposed to environmental tobacco smoke. Twelve percent of the newborn DBS had cotinine levels that were ≥9.0 ng/g (equivalent to 6 ng/mL plasma, a level that indicates active smoking of the mother), although 41% of the mothers of these infants reportedly did not smoke. CONCLUSIONS These data confirm that reported smoking during pregnancy is an imperfect measure of prenatal tobacco smoke exposure. Cotinine assessment in newborns may improve surveillance of tobacco use during pregnancy.
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Affiliation(s)
- Logan G. Spector
- Departments of Pediatrics,,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Sharon E. Murphy
- Biochemistry, Molecular Biology, and Biophysics, and,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | | | - Bruce Lindgren
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Anne M. Joseph
- Medicine, University of Minnesota, Minneapolis, Minnesota; and,Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
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18
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Botler J, Camacho LAB, Cruz MMD. Avaliação das unidades de coleta do Programa de Triagem Neonatal no Estado do Rio de Janeiro. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2012. [DOI: 10.1590/s1519-38292012000400009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVOS: avaliar estrutura e processo das unidades de coleta (UC) e incluindo coleta e transporte das amostras, e busca ativa do Programa de Triagem Neonatal do Estado do Rio de Janeiro (PTN-RJ). MÉTODOS: foram selecionadas 66 das 422 UC existentes, conforme tipo, localização e volume de amostras. Foram aplicados questionário semi-estruturado e roteiros para observação direta e análise documental. Foram gerados escores para estrutura e processo para cada UC. Foram calculadas medianas da pontuação, avaliada a consistência interna do instrumento, correlação de escores entre estrutura e processo. RESULTADOS: o escore mediano global (máximo de 100) foi de 69,1 (variação: 50,5-86,6) para estrutura e 63,9 (variação: 46,9-77,4) para processo. O desempenho das UC foi semelhante em estrutura. Maternidades e PSF tiveram desempenhos superiores em processo, e UCB inferiores. O coeficiente alfa de Cronbach indicou alta consistência dos instrumentos para avaliação de estrutura (alfa=0,93) e processo (alfa=0,81). Os escores de estrutura e processo apresentaram fraca correlação (coeficiente de Pearson = 0,44; Spearman = 0,42). Diferenças nos escores médios entre tipos de UC demonstraram considerável magnitude, porém sem significância estatística (p=0,387). CONCLUSÕES: o desempenho global em estrutura e processo foi satisfatório. As deficiências foram encontradas na capacitação de profissionais e suprimento de material para coleta e educativo.
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Mak C, Lam C, Law C, Siu W, Kwong L, Chan K, Chan W, Chow K, Lee K, Chan W, Chan A. Parental attitudes on expanded newborn screening in Hong Kong. Public Health 2012; 126:954-9. [DOI: 10.1016/j.puhe.2012.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 04/07/2012] [Accepted: 08/02/2012] [Indexed: 12/20/2022]
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20
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Korzeniewski SJ, Grigorescu V, Kleyn M, Young W, Birbeck GL, Todem D, Romero R, Chaiworapongsa T, Paneth N. Performance metrics after changes in screening protocol for congenital hypothyroidism. Pediatrics 2012; 130:e1252-60. [PMID: 23045555 PMCID: PMC3483888 DOI: 10.1542/peds.2011-3340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate Michigan newborn screening for congenital hypothyroidism (CH) protocol changes. METHODS This population-based study includes infants born and screened in Michigan (January 1, 1994-June 30, 2010). Screening performance is compared across 4 periods defined by the dried blood spot testing method: (1) thyroxine (T4) with backup thyrotropin, (2) tandem T4 and thyrotropin, (3) primary thyrotropin testing without serial testing, and (4) primary thyrotropin plus serial testing for births weighing <1800 g. Logistic regression is used to test for differences across periods. RESULTS Thyrotropin testing exhibited greater specificity overall and greater likelihood of detection with serial testing relative to primary T4 testing. Tandem T4 and thyrotropin testing appeared more sensitive relative to other protocols, yet it produced significantly more false-positives, and detection may have been affected by overdiagnosis and misclassification. Central CH was no longer detected once T4 testing ceased. CONCLUSIONS Primary thyrotropin plus serial testing for infants at risk for later rising thyrotropin outperformed other newborn screening strategies for classic CH, although 2 false-negatives occurred among normal birth weight infants admitted to the NICU during this testing period. Tandem T4 and thyrotropin screening outperformed other strategies for detection of both classic and central CH combined, although it is associated with increased operating costs. Additional research is necessary to weigh the benefits of increased sensitivity against additional program operating costs.
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Affiliation(s)
- Steven J. Korzeniewski
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Detroit, Michigan;,Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | | | - Mary Kleyn
- Michigan Department of Community Health, Lansing, Michigan; and
| | - William Young
- Michigan Department of Community Health, Lansing, Michigan; and
| | - Gretchen L. Birbeck
- Department of Epidemiology, Michigan State University, East Lansing, Michigan
| | - David Todem
- Department of Epidemiology, Michigan State University, East Lansing, Michigan
| | - Roberto Romero
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Detroit, Michigan
| | - Tinnakorn Chaiworapongsa
- Perinatology Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Detroit, Michigan;,Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan
| | - Nigel Paneth
- Department of Epidemiology, Michigan State University, East Lansing, Michigan
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21
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Therrell BL, Wu C. Including the initial newborn screening bloodspot collection device serial number on birth certificates: basis and recommendations from the Secretary of Health and Human Services’ Advisory Committee on Heritable Disorders in Newborns and Children. Genet Med 2012; 15:229-33. [DOI: 10.1038/gim.2012.121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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22
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Consolidating newborn screening efforts in the Asia Pacific region : Networking and shared education. J Community Genet 2012; 3:35-45. [PMID: 22271560 DOI: 10.1007/s12687-011-0076-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Accepted: 12/26/2011] [Indexed: 11/27/2022] Open
Abstract
Many of the countries in the Asia Pacific Region, particularly those with depressed and developing economies, are just initiating newborn screening programs for selected metabolic and other congenital disorders. The cultural, geographic, language, and economic differences that exist throughout the region add to the challenges of developing sustainable newborn screening systems. There are currently more developing programs than developed programs within the region. Newborn screening activities in the Asia Pacific Region are particularly important since births there account for approximately half of the world's births. To date, there have been two workshops to facilitate formation of the Asia Pacific Newborn Screening Collaboratives. The 1st Workshop on Consolidating Newborn Screening Efforts in the Asia Pacific Region occurred in Cebu, Philippines, on March 30-April 1, 2008, as a satellite meeting to the 7th Asia Pacific Conference on Human Genetics. The second workshop was held on June 4-5, 2010, in Manila, Philippines. Workshop participants included key policy-makers, service providers, researchers, and consumer advocates from 11 countries with 50% or less newborn screening coverage. Expert lectures included experiences in the United States and the Netherlands, international quality assurance activities and ongoing and potential research activities. Additional meeting support was provided by the U.S. National Institutes of Health, the Centers for Disease Control and Prevention, the U.S. National Newborn Screening and Genetics Resource Center, the International Society for Neonatal Screening, and the March of Dimes. As part of both meeting activities, participants shared individual experiences in program implementation with formal updates of screening information for each country. This report reviews the activities and country reports from two Workshops on Consolidating Newborn Screening Efforts in the Asia Pacific Region with emphasis on the second workshop. It also updates the literature on screening activities and implementation/expansion challenges in the participating countries.
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23
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Vela-Amieva M, Ibarra-González I, Fernández-Lainez C, Monroy-Santoyo S, Guillén-López S, Belmont-Martínez L, Hernández-Montiel A. Causes of delay in referral of patients with phenylketonuria to a specialized reference centre in Mexico. J Med Screen 2011; 18:115-20. [DOI: 10.1258/jms.2011.011028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective To expose causes leading to the delayed arrival of phenylketonuria (PKU) patients at a governmental reference centre (RC), and to describe their clinical characteristics. Material and methods PKU files registered during the past 18 years at the National Institute of Pediatrics in Mexico City were evaluated. Patients were classified into two groups according to their age at arrival: Group I (early reference), patients arriving during the first month of life; and Group II (late reference), those who arrived after thirty days of age. Time and causes of delay were documented. Results Of 57 recorded files, 10 were classified in Group I and 47 in Group II. Causes leading to the late arrival of Group II patients were absence of routine newborn screening (NBS), PKU not included in the routine NBS, sampling after the recommended age, false negative result, results without interpretation and/or instructions to follow, delayed notification of results, poor medical criteria of attending physician, difficulties in obtaining confirmatory tests, and administrative failures. Conclusion The main cause of late referral of PKU patients was the absence of PKU testing. As a developing country, Mexico still faces challenges in the proper functioning and expansion of the NBS programme. Most PKU patients arrived at the RC late, presenting with varying degrees of the clinical spectrum. Incorporating PKU testing into the already established Mexican NBS system and adding quality indicators to guarantee proper operation in all NBS phases is necessary to achieve the goal of identifying, referring, diagnosing, and treating patients promptly.
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Affiliation(s)
- M Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, México
| | - I Ibarra-González
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México
| | - C Fernández-Lainez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaríade Salud, México
| | - S Monroy-Santoyo
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaríade Salud, México
| | - S Guillén-López
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaría de Salud, México
| | - L Belmont-Martínez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaríade Salud, México
| | - A Hernández-Montiel
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Instituto Nacional de Pediatría, Secretaríade Salud, México
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