Success-Stories-on-Health-Sector

KErala
nEwborn sCrEEning ProgrammE
ProblEm statEmEnt
There was no detailed study of inborn error of
metabolism in kerala. Congenital Hypothyroidism
was present in the community and it was necessary to
ensure that the excellent work undertaken by the Health
Services department is in pace with the best international
practices for early detection and intervention of selected
disorders to prevent serious consequences like mental
retardation.
ProgrammE DEsCriPtion
newborn screening test aims at the early detection of
disorders to prevent serious consequences by timely
interventions. The current NBS programme of Kerala
provides screening tests for Congenital Hypothyroidism,
Congenital adrenal Hyperplasia, Phenyl ketonuria and
Glucose-6 Phosphate Dehydrogenase deficiency which are
carried out through the four PH labs. (State PH Lab and
three Regional PH Labs).
ProgrammE outComEs
During the period from March 2013 to Feb 2015, a total of
115279- cases have been screened.
FinanCial invEstmEnt
The required funds are provided through the State plan
as well as nRHM and the programme is implemented
free-of -cost to the beneficiaries.
sCalabilitY
The NBS programme can be implemented in any of the
States after arranging the following facilities:
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Equipping selected government laboratories for starting
NBS screening tests (equipment, test-kits, reagents, HR
provision and necessary training should be given).
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Selection of delivery-conducting hospitals for running
the programme.
NBS sample collection and transportation guidelines
should be given to the hospitals.
Timely dispatch of test results from the laboratory to
concerned institutions(by email).
In the second phase, the NBS programme may be
extended to all the delivery-conducting government
Hospitals in Kerala. Screening for Congenital
Hypothyroidism and Congenital adrenal
Hyperplasia has to be continued.
Phenyl ketonuria can completely be excluded and
G6PD may also be excluded, since the consequences
associated with G6PD is less serious when compared
to Congenital Hypothyroidism and also considering
the financial viability when all the Government
hospitals are included under the programme.
The government may give direction to private
hospitals in the State to screen the babies for at least
Congenital Hypothyroidism at their own facility since
there is a high prevalence in the State.
inclusion of any other inborn error of metabolism
screening under the programme can be considered
after discussion with the Senior Clinicians.
ConClusions/lEssons lEarnt
new born screening programme of kerala is one of the
most advanced and successful programmes implemented
in the recent past. This is the first expanded pilot
programme of the State where 44 selected Government
hospitals are included covering all the 14 districts.
Since this report is based on the two years of data of New
Born Screening Programme of Kerala, it more or less
gives the actual prevalence of the selected inborn errors of
metabolism:
• The most common disorder detected through this
programme is Congenital Hypothyroidism (67
Confirmed cases), that shows a prevalence of one in
1720 cases. all these babies are on treatment now.
Early detection of Congenital Hypothyroidism
through NBS programme has helped to prevent
serious consequences like mental retardation in these
babies.
• There was not a single positive case of Phenyl ketonuria
found through the screening.
• Two confirmed cases of Congenital Adrenal
Hyperplasia are there, that shows a prevalence of one
in 57634 only.
• 9 confirmed cases of G6PD Deficiency, which shows a
prevalence of one in 12809 cases.
The selected government hospitals participated in the
programme with varying levels of enthusiasm with
major delivery-conducting hospitals being more
enthusiastic.
rEFErEnCE
New Born Screening in India, NHS Programme in UK.
126 | Making a Difference : good, Replicable and innovative Practices