Biliary atresia screening in Shenzhen: implementation and achievements

Area of Science:

• Pediatric Surgery
• Public Health Initiatives
• Gastroenterology

Background:

• Biliary atresia (BA) is a severe neonatal liver disease requiring early intervention.
• Timely diagnosis and treatment significantly improve patient outcomes.
• A public health screening program using the stool color card (SCC) was implemented in Shenzhen in 2015.

Purpose of the Study:

• To evaluate the implementation and effectiveness of the BA screening program in Shenzhen.
• To assess the impact of the SCC-based screening on key diagnostic and prognostic indicators.

Main Methods:

• The stool color card (SCC) was integrated into maternal and child health handbooks distributed to all pregnant women in Shenzhen starting January 1, 2015.
• 118 BA patients were divided into two cohorts: pre-screening (Cohort A) and post-screening (Cohort B).
• Key outcomes including age at diagnosis, jaundice-free rate, and 2-year native liver survival rate were compared between cohorts.

Main Results:

• The screening program significantly reduced the median age at diagnosis from 81 to 56 days (p<0.05).
• Postoperative complication rates decreased, while the jaundice-free rate and 2-year native liver survival rate increased significantly (p<0.05).
• The rate of patients undergoing surgery increased from 68.0% to 83.8% (p<0.05).

Conclusions:

• The Shenzhen BA screening program, utilizing the SCC, led to earlier diagnosis and improved patient prognoses.
• The program demonstrated a successful hospital-government collaboration with significant benefits and low implementation costs.
• Results support the wider adoption of the SCC for biliary atresia screening nationwide.