Indicators of newborn screening for congenital hypothyroidism in Sri Lanka: program challenges and way forward

BMC Health Services Research

Sujeewa Amarasena²  Manjula Hettiarachchi¹ 

[1] Nuclear Medicine Unit, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka;Department of Pediatrics, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

关键词: Program challenges;    Sri Lanka;    Congenital hypothyroidism;    Newborn screening;   

Others  :  1126496
DOI  :  10.1186/1472-6963-14-385

 received in 2013-09-07, accepted in 2014-09-09,  发布年份 2014

【 摘 要 】

Background

Many of the countries in the Asia Pacific Region are just initiating newborn screening programs for selected metabolic and other congenital disorders. The present study is aimed at evaluating the congenital hypothyroidism screening program in the Southern region of Sri Lanka in terms of coverage, effectiveness of detecting and managing the cases.

Methods

The Newborn Screening System Database of Sri Lanka was reviewed from January 2011 to December 2012. The data of 47 babies who tested positive for hypothyroidism were analyzed.

Results

Total of 78,167 babies (99.0% of live births) were screened. Of them, 5.8% (n = 4,472) were discharged within 12 hrs of delivery where as 58.1% (n = 44969) were discharged afterwards but within next 12 hrs (i.e., day 1). The positive predictive value for congenital hypothyroidism (CH) was 9.0%. The incidences of primary CH among screened infants were 1:1682. False positive rate among screened infants was maintained below 0.70%. Mean age of serum confirmation was 23.8 (±8) days.

Conclusions

In the light of the present findings, we would suggest direct communication systems, linking newborn screening program to the family unit. This would enhance timely follow-up for screen-positive infants and facilitate information sharing. Establishing a program with, public-private sector partnership should be considered. Costs could be contained if the specimen collection, its transportation and communication are carried out by this partnership and the laboratory tests are conducted by a non-profit organization such as a University in order to achieve the goal of universal coverage.

【 授权许可】

   
2014 Hettiarachchi and Amarasena; licensee BioMed Central Ltd.

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