建立一个新生儿查计划:一个成功的故事从一个低资源设置
Hafsa Majid1, Lena Jafri1, Sibtain Ahmed1
1Department of Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan.
概括
在三级医疗中心对新生儿进行先天性甲状腺功能低下症 (CH) 查证明非常有效,确定了27例病例,发病率为1:1126. 提高积极查结果的召回率仍然是增强的关键领域.
科学领域:
- 内分泌学 在内分泌学.
- 新生儿科学 新生儿科学
- 公共卫生 公共卫生
背景情况:
- 先天性甲状腺功能低下症 (CH) 是一种可治疗的疾病,需要早期诊断.
- 新生儿查 (NBS) 计划对于及时检测和管理心血管疾病至关重要.
- 高等保健中心在管理复杂的儿科内分泌疾病方面发挥着至关重要的作用.
研究的目的:
- 评估新生儿查计划对先天性甲状腺功能低下症的临床有效性.
- 为了确定由第三级护理中心服务的定义人口中CH的发病率.
- 评估在五年内对CH的NBS的实施和结果.
主要方法:
- 从2019年1月到2023年12月进行的横截面研究设计.
- 在24小时以上的新生儿中,测试甲状腺刺激激素 (TSH) 的干血斑点 (DBS) 测试.
- 阳性TSH结果 (>10mIU/L) 与血清TSH和自由T4 (FT4) 水平的确认,随后由儿科内分泌科医生转诊.
主要成果:
- 查覆盖率达到96.2%的31,610个出生总数,其中30402名新生儿进行了查.
- 1.9% (n=586) 的新生儿初始查结果呈阳性 (TSH>10 mIU/L).
- 在27个病例中确认了CH,产生1:1126的发病率;在63.13%的阳性查中进行了确认测试.
结论:
- 顺利实施了新生儿先天性甲状腺功能低下症查计划,并证明了其高临床有效性.
- 1:1126的确定的CH发病率强调了持续查工作的重要性.
- 提高初始查结果为阳性新生儿的召回率是必要的,以进一步优化该计划的影响.
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