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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Evolution of the neonatal screening program in the state of Tocantins]
Lucas Corrêa Mendes1, Taides Tavares dos Santos, Fabiana de Andrade Bringel
1Faculdade de Ciências Humanas, Econômicas e da Saúde de Araguaína, Instituto Tocantinense Presidente Antônio Carlos (FAHESA/ITPAC), Araguaína, TO, Brasil.
Insights
Neonatal screening in Tocantins improved coverage significantly, but delays in sample collection and treatment initiation for phenylketonuria (PKU) and congenital hypothyroidism (CH) require further attention and government support.
Area of Science:
- Public Health
- Pediatrics
- Genetics
Background:
- The Neonatal Screening Program (NSP) is crucial for early detection of metabolic and endocrine disorders in newborns.
- Evaluating the NSP's effectiveness in Tocantins provides insights into regional public health program implementation.
Purpose of the Study:
- To assess the performance and outcomes of the Neonatal Screening Program in Tocantins, Brazil, between 1995 and 2011.
- To identify areas for improvement in the screening and management of phenylketonuria (PKU) and congenital hypothyroidism (CH).
Main Methods:
- A mixed-methods approach was used, including interviews with service providers and parents/guardians.
- Medical records of patients diagnosed with PKU and CH within the program were analyzed.
Main Results:
- Program coverage expanded from 32.3% to 76.6% following the National Newborn Screening Program (PNTN) implementation.
- Prevalence rates for PKU and CH were 1:28,309 and 1:4,632 live births, respectively.
- Mean ages for initial blood sample collection and treatment initiation exceeded recommended guidelines for both PKU and CH.
Conclusions:
- Despite progress, the Neonatal Screening Program in Tocantins requires enhanced government funding and strategic development to reach its full potential.
- Optimizing the timeliness of diagnosis and treatment initiation is essential for improving outcomes for newborns screened for PKU and CH.
Objective:
To evaluate the Neonatal Screening Program in the State of Tocantins from 1995 to 2011.
Materials And Methods:
Data collection was conducted by means of interviews with those responsible for the service, by the analysis of medical records of patients diagnosed with phenylketonuria (PKU) and congenital hypothyroidism (CH) that were enrolled in the program, and by interviews with parents and/or guardians of the patients monitored.
Results:
Program coverage increased from 32.3% to 76.6% after the implementation of the National Newborn Screening Program (PNTN). The prevalence of PKU and CH was 1:28,309 and 1:4,632 live births, respectively. The mean ages at the collection of the first blood sample (PKU: 9.6 ± 6.3 days; CH: 13.3 ± 10.3 days) and at the beginning of the treatment (PKU: 57.0 ± 17.6 days; CH: 95,6 ± 57.6 days) were greater than recommended by the Ministry of Health. The quality of monitoring was considered satisfactory by 100% of the parents.
Conclusion:
Although there have been great developments in neonatal screening program in this state, there is need for greater government incentives to optimize the program and to make the PNTN advance to its next phases.
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