Neonatal screening for sickle cell disease in France: evaluation of the selective process

被引:21
|
作者
Thuret, Isabelle [2 ,3 ]
Sarles, Jacques [3 ,4 ]
Merono, Francoise [5 ]
Suzineau, Eliane [6 ]
Collomb, Jacques [6 ]
Lena-Russo, Danielle [5 ]
Levy, Nicolas [1 ,5 ]
Bardakdjian, Josiane [7 ]
Badens, Catherine [1 ,3 ,5 ]
机构
[1] Hop Enfants La Timone, Genet Mol Lab, F-13385 Marseille 5, France
[2] Hop Enfants La Timone, Serv Hematol Pediat, F-13385 Marseille 5, France
[3] Hop Enfants La Timone, Assoc Reg Depistage & Etud Encephalopathies & Aff, F-13385 Marseille 5, France
[4] Hop Enfants La Timone, Serv Pediat Multidisciplinaire, F-13385 Marseille 5, France
[5] Fac Med Marseille, Ctr Enseignement & Rech Genet Med, F-13385 Marseille, France
[6] Conseil Gen Bouches Rhone, Direct Sante, Marseille, France
[7] Hop Henri Mondor, Biochim Lab, F-94010 Creteil, France
关键词
COST-EFFECTIVENESS ANALYSIS; HEMOGLOBINOPATHIES; UNIVERSAL;
D O I
10.1136/jcp.2009.068874
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Aims The French national programme for neonatal screening of sickle cell disease is applied to newborns 'at risk', defined as those born to parents originating from sub-Saharan Africa, the Mediterranean area, the Arabic peninsula, the French overseas islands and the Indian subcontinent. The selection is performed by the nurse in charge of blood sampling by interviewing the mother about the family's geographical origins. The mean rate of testing in France is 25%, ranging from 2% to 50% depending on the region. This study aimed to evaluate the effectiveness of selection during this screening programme. Methods False-negative cases were identified using two different approaches: first, a regional prospective study aimed at screening all newborns, selected and non-selected, in a restricted area, representing 3% of national births; second, a retrospective national survey to identify false-negative cases. Results The regional study indicated that selective screening leads to a carrier frequency that is twice as high in the selected population as compared with the non-selected population (1.23% versus 0.62%). The local and national surveys revealed that, during a 6-year period, 28 affected children failed to be selected, leading to a false-negative rate of 2.1%. In contrast to what was expected, most of the cases were due to the failing of the data collection process and not to the misdiagnosis of the risk. Conclusions These results show that selective neonatal screening for sickle cell disease is feasible if very careful attention is paid to the selective step.
引用
收藏
页码:548 / 551
页数:4
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