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Audit of the Congenital Hypothyroidism Screening Program in 15 Provinces of Iran

Ladan Mehran1, Shahin Yarahmadi2, Davood Khalili3

  • 1Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Archives of Iranian Medicine
|July 30, 2019
PubMed

Insights

Iran's national newborn screening program for congenital hypothyroidism (CH) shows good coverage but a high false positive rate. Further improvements are needed for neonatal TSH levels and screening accuracy.

Area of Science:

  • Public Health
  • Endocrinology
  • Neonatal Medicine

Background:

  • The national newborn screening (NBS) program for congenital hypothyroidism (CH) was established in Iran in 2005.
  • This study evaluates the NBS program's effectiveness in 15 provinces between 2011 and 2014.

Purpose of the Study:

  • To assess the performance and identify challenges within Iran's national newborn screening program for congenital hypothyroidism.
  • To evaluate key indicators such as program coverage, diagnostic accuracy, incidence rates, and treatment initiation.

Main Methods:

  • Retrospective analysis of aggregated screening, diagnosis, and management data from 17 districts across 15 provinces in 2011.
  • Data included screening coverage, positive predictive value, transient CH prevalence, sampling errors, recall rates, CH incidence, screening age, treatment timing, and TSH normalization time.

Main Results:

  • Program coverage was high (77-100%), but the positive predictive value was low (1.3-15.5%).
  • Congenital hypothyroidism incidence was notable (highest: 1:241 in Zanjan), with transient CH observed in over 3% of neonates in some districts.
  • Screening and treatment initiation generally occurred within recommended timeframes, but TSH normalization varied significantly.

Conclusions:

  • Key performance indicators for the NBS program have met national goals.
  • High false positive rates and non-optimal neonatal TSH levels require further investigation and program refinement.
Abstract

Keywords:
Congenital hypothyroidismEvaluationNewbornScreening

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