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.
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
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.
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)
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
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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