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Newborn screening for cystic fibrosis in Serbia: a pilot study
Danijela Radivojevic1, Aleksandar Sovtic, Predrag Minic
1Laboratory of Medical Genetics, Mother and Child Health Institute of Serbia, Belgrade, Serbia. badane@beotel.rs
Insights
A pilot study successfully screened 1000 newborns for cystic fibrosis (CF) in Serbia. The results support integrating CF neonatal screening into the national program, identifying two infants with CF.
Area of Science:
- Neonatal screening
- Genetics
- Public health
Background:
- Pilot study conducted in Serbia to evaluate neonatal screening for cystic fibrosis (CF).
- Aims to integrate CF screening into the national healthcare program.
- Focuses on early detection of CF in newborns.
Purpose of the Study:
- To assess the feasibility and effectiveness of a neonatal screening program for cystic fibrosis in Serbia.
- To identify potential cases of CF in newborns using a multi-tiered approach.
- To gather data for the potential expansion of routine CF screening.
Main Methods:
- Analysis of immunoreactive trypsinogen (IRT) in dried blood spots.
- Recall for repeat measurements in cases of elevated IRT.
- DNA testing for common CF transmembrane regulator (CFTR) gene mutations (IRT/IRT/DNA method).
- Sweat chloride measurements and clinical assessments for confirmed diagnoses.
Main Results:
- Screened 1000 neonatal blood samples.
- Identified three initially positive samples.
- DNA analysis confirmed two infants homozygous for the F508del CFTR mutation.
- One sample was a false positive, with negative genetic tests and normal clinical findings.
Conclusions:
- The pilot study's findings support the expansion of routine neonatal screening for cystic fibrosis in Serbia.
- The data collected can inform future incidence and carrier prevalence studies.
- Successful implementation of IRT/IRT/DNA method for CF screening.
Background:
We performed a pilot study of neonatal screening for cystic fibrosis (CF) in order to introduce it to the national screening program in Serbia.
Methods:
Immunoreactive trypsinogen (IRT) concentrations were analyzed in dried blood spot samples. Patients were recalled for repeated measurements in case of high IRT levels. Persisting high IRT levels resulted in DNA testing for the 29 most common mutations in the CF transmembrane regulator (CFTR) gene (IRT/IRT/DNA method). Sweat chloride measurements and clinical assessment were further performed for newly diagnosed patients.
Results:
Of 1000 samples, three were initially positive and were further analyzed for the presence of the most common CFTR mutations in the Serbian population. DNA analysis revealed two patients being homozygous for F508del mutation. One sample was false positive, as the genetic test proved to be negative and associated with normal sweat chloride concentration and unremarkable clinical presentation.
Conclusions:
The results of our pilot study justified the expanding of the routine neonatal screening program in Serbia with CF. Data could be used in future in order to obtain accurate incidence of CF and carrier prevalence in our country.
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