Implementation of Neonatal Screening Program for Congenital Hypothyroidism in Eastern Morocco

Area of Science:

• Endocrinology
• Public Health
• Neonatal Medicine

Background:

• Congenital hypothyroidism (CH) is a leading preventable cause of intellectual disability worldwide.
• Early detection through newborn screening (NBS) is crucial for timely intervention and improved outcomes.
• Limited data exists on CH incidence and NBS program effectiveness in eastern Morocco.

Purpose of the Study:

• To evaluate the incidence of CH in eastern Morocco using a newborn screening program.
• To assess the effectiveness of the NBS program in detecting CH cases.
• To identify potential delays in the screening and diagnostic process.

Main Methods:

• A descriptive cross-sectional study involving 4062 newborns in eastern Morocco.
• Heel prick blood samples collected on blotting paper for Thyroid-Stimulating Hormone (TSH) measurement via immunofluorimetric assay.
• Analysis of TSH levels, recall rates, confirmatory testing results, and preanalytical/turnaround times.

Main Results:

• The birth prevalence of CH confirmed at birth was 1:1354 live births.
• TSH levels varied significantly by neonatal age at sampling (p < 0.001).
• A recall rate of 0.44% was observed, with 3 confirmed CH cases and 4 cases of transient hyperthyrotropinemia.

Conclusions:

• The NBS program in eastern Morocco is relevant for detecting CH, a preventable cause of intellectual disability.
• Significant delays in preanalytical steps (median 6 days) and TSH result turnaround (median 8 days) were noted.
• Addressing these delays is essential to enhance early diagnosis and management of CH in the region.