Archive February 2008
CHILD HEALTH SCREENING


What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?

 

Statistics
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Links
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Documents
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What we know

Screening in childhood is extremely important. This should be the time to build on the relationship between health professionals and parents established in the antenatal and neonatal stages, to encourage sensible habits in relation to the child’s health, and to detect abnormalities or disorders at an early stage when effective treatment or intervention is available. Screening in childhood is a specific contact made by a health care worker with a child to identify any mental or physical disorder, defects of sight or hearing and so on.

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What information do we have about the Eastern Board area?

There are a number of childhood conditions where early intervention can improve outcome and for which appropriate screening tests/procedures exist.

The National Screening Committee (NSC) advises Government on screening policy and quality assurance. Currently the NSC supports screening for infants/children for the following conditions:

Phenylketonuria
Congenital hypothyroidism
Cystic fibrosis
Sensori-neural hearing impairment
Dislocation of the hip
Visual impairment including cataract and squint
Congenital heart disease
Congenital anomalies
Cryptorchidism (undescended/malpositioned testes)
Sickle Cell Disease

Condition Frequency Impact of Screening on Health
Phenylketonuria 1 in 4000 births Early diagnosis and compliance with treatment prevents progressive brain damage
Congenital hypothyroidism 1 in 3500 births Early diagnosis and compliance with treatment prevents progressive brain damage
Cystic fibrosis 1 in 2000 births Earlier diagnosis
Sensori-neural hearing impairment 1 in 1000 births Earlier diagnosis, and treatment and improved speech development
Dislocation of the hip 1 in 800 births May reduce the need for open surgery
Visual impairment including cataract and squint 1 in 1000 infants/children Earlier diagnosis and intervention may prevent deterioration in vision
Congenital heart disease 1 in 125 births Earlier diagnosis
Cryptorchidism (undescended/malpositioned testes) 1 in 16 male births Earlier diagnosis and intervention to correct position may reduce risk of infertility and cancer
Sickle Cell Disease 1 in 2000-10,000 births Earlier diagnosis and improved morbidity and mortality

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What is the result of this on our health locally?

Screening can never be 100% accurate, i.e. it cannot identify all cases. Generally, screening identifies a group of infants/children at increased risk of a condition. Diagnostic tests are then offered/carried out. ‘Abnormal’ screening results may also occur among infants/children who do not have the condition being screened for (false positives). Thus screening may result in unnecessary anxiety and investigations, which may have adverse effects. In addition, for some conditions, an abnormality may develop following a 'normal' screening result.

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Policies

In Northern Ireland the policy of the Department of Health, Social Services and Public Safety is for the following screening programmes to be provided to all newborn infants and children:

Phenylketonuria
Congenital hypothyroidism
Cystic fibrosis
Sensori-neural hearing impairment
Dislocation of the hip
Visual impairment including cataract and squint
Congenital heart disease
Congenital anomalies
Cryptorchidism (undescended/malpositioned testes)

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What is happening in the Eastern Board area?
Condition Practice in Eastern Area
Phenylketonuria
Congenital hypothyroidism
Cystic fibrosis
Part of bloodspot screening in first week of life ('heelprick' test)
Sensori-neural hearing impairment Distraction test at 7 months. Universal neonatal hearing screening using automated otocoustic emissions (AOAE) testing planned to commence in April 2005
Visual impairment including cataract and amblyopia (squint) Eyes examined at/soon after birth. Further examination carried out pre-school and in school
Congenital anomalies including congenital heart disease Examination at/soon after birth and at 8 week examination
Cryptrorchidism (undescended/malpositioned testes) Examination at/soon after birth and at 8 week examination

 

 

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For further information on this topic please contact us at publichealth@ehssb.n-i.nhs.uk

Eastern Health and Social Services Board Champion House, 12-22 Linenhall Street, Belfast BT2 8BS Telephone: (028) 9032 1313 Fax: (028) 9055 3681 Text Phone:(028) 9032 4980 Website: www.ehssb.org E-mail: pr@ehssb.n-i.nhs.uk
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