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Neonatal screening in Hong Kong and Macau
Insights
Hong Kong
Area of Science:
- Public Health
- Neonatal Screening
- Genetics
Background:
- Neonatal screening programs require careful consideration of public health impact, system feasibility, and social factors.
- Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency and Congenital Hypothyroidism (CHT) were identified for screening in Hong Kong in the early 1980s.
Purpose of the Study:
- To detail the implementation and evaluate the outcomes of Hong Kong's territory-wide neonatal screening program for G6PD deficiency and CHT.
- To present the methodology and results of G6PD deficiency screening in Macau.
Main Methods:
- A territory-wide screening program for G6PD deficiency and CHT was implemented in Hong Kong in 1984, achieving over 99% newborn coverage.
- Pre-screening education was provided to 95% of pregnant women through Department of Health centers.
- G6PD deficiency screening began in Macau in 1977 in one major hospital.
Main Results:
- In Hong Kong, the incidence of CHT was 1 in 2404, and G6PD deficiency affected 4.5% of males and 0.3% of females.
- Over 99% of Hong Kong newborns have been screened since the program's inception.
- Macau has initiated G6PD deficiency screening but not CHT screening.
Conclusions:
- Hong Kong's comprehensive neonatal screening program for G6PD deficiency and CHT has achieved high coverage and provided valuable incidence data.
- The study highlights the importance of public health impact, system feasibility, and social considerations in establishing effective neonatal screening programs.
- Comparative data on screening programs in Hong Kong and Macau are presented.
Abstract:
For the implementation of the neonatal screening program, the following factors have to be considered for the selection of conditions to be screened and evaluation of outcome. These include the factors pertaining to public health impact, availability and acceptability of the screening system, and other social issues involved in the implementation. In the context of Hong Kong, Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency and Congenital Hypothyroidism (CHT) have been highlighted in the early 1980s for consideration. A territory wide program for screening these conditions was started in 1984. Since then, over 99% of all newborns in Hong Kong was screened. Of these, around 70% were delivered in public hospitals, and the remaining were from private hospitals. Pre-screening education was emphasized, and 95% of pregnant ladies received information about this screening program from the Maternity and Child Health Centers run by the Department of Health, Hong Kong. For those who were born in public hospitals, the incidence of CHT was 1 in 2404 (269/646,580), while that of G6PD deficiency was 4.5% in male newborns and 0.3% in female newborns. This paper highlights details of the screening program, including its outcome evaluation. In Macau, CHT screening has not been started. Instead, G6PD deficiency screening commenced in 1977 in one of the two major hospitals where most newborns are delivered. Methodology and results of this program are presented.
