Articles

Assessing the Phenylketonuria Screening Program in Newborns, Iran 2015-2016

Abstract

Phenylketonuria is one of the most important congenital disorders and an autosomal recessive metabolic disease that can cause irreversible brain damages, mental retardation, and cognitive disorders if left untreated. In order to reduce the genetic abnormalities caused by this metabolic disease, screening programs are implemented. The quality of the program must be properly assessed to achieve the objectives of this program if promoting children's health is of concern. The descriptive-analytic method is adopted here to assess the phenylketonuria screening program in practice in Chaharmahal and Bakhtiari province since 2012 and analyze the incidence and program coverage. The quality of the screening program is assessed through analyzing the time of diagnosis, beginning of the treatment and the healthcare centers’ facilities with checklists. The parental and the staff awareness is assessed through knowledge measuring questionnaires. Cumulative incidence of phenylketonuria in Chaharmahal and Bakhtiari province from 2012 to 2015, is 1 in every 6662 live births. The program coverage across the region is 100%. The recorded on-time sampling index before 5 days of age, indicate 84.6 % in 2015 from 80% in 2012. The treatment begun before the newborn 4 weeks was over in all cases. Program sensitivity was 100 %, and its specificity was 99.9%. Staff awareness is fair with no impact on parental awareness. General quality of the screening program is appropriate, and as to sensitivity and on-time curing specificity, higher staff and parental awareness supervision are recommended as well.

Kaur A, Singh JR. Chromosomal abnormalities: Genetic disease burden in India. Int J Hum Genet 2010;10:1-14

Loeber JG. Neonatal screening in Europe; the situation in 2004. J Inherit Metab Dis 2007;30:430-8.

Williams RA, Mamotte CDS, Burnett JR. Phenylketonuria: an inborn error of phenylalanine metabolism. Clin Biochem Rev 2008;29:31-41.

Birk Møller L, Nygren AO, Scott P, Hougaard P, Bieber Nielsen J, Hartmann C, et al. Low proportion of whole exon deletions causing phenylketonuria in Denmark and Germany. Hum Mutat 2007;28:207.

Hatam N, Askarian M, Shirvani S, Pourmohammadi K. Cost Utility of Neonatal Screening Program for Phenylketonuria in Shiraz University of Medical Sciences. Hakim Res J 2014;16:329- 36.

Koochmeshgi J, Bagheri A, Hosseini Mazinani SM. Incidence of phenylketonuria in Iran estimated from consanguineous marriages. J Inherit Metab Dis 2002;25:80-1.

Vallian S, Barahimi E, Moeini H. Phenylketonuria in Iranian population: a study in inustitutins for mentally retarted in Isfehan. Mutat Res 2003;526:45-52.

Holmgren G, Larsson A, Palmstierna H, Alm J. The frequency of PKU and hyperphenylalaninemia in Sweden-a study in institutions for the mentally retarded as well as in neonates. Clin Genet 1976;10:313-8.

DiLella AG, Woo SL. Molecular basis of phenylketonuria and its clinical applications. Mol Biol Med1987;4:183-92.

Watson MS, Mann MY, Lloyd-Puryear M, Rinaldo P, Howell RR. American College of Medical Genetics Newborn Screening Expert Group. Newborn screening: toward a uniform screening panel and system—executive summary. Pediatrics 2006;117:5296-307

Burton BK, Leviton L, Vespa H, Coon H, Longo N, Lundy BD, et al. A diversified approach for PKU treatment: routine screening yields high incidence of psychiatric distress in phenylketonuria clinics. Mol Genet Metab 2013;108:8-12.

Gentile JK, Ten Hoedt AE, Bosch AM. Psychosocial aspects of PKU: hidden disabilities—a review. Mol Genet Metab 2010;99:64-7.

Camp KM, Lloyd-Puryear MA, Yao L, Groft SC, Parisi MA, Mulberg A, et al. Expanding research to provide an evidence base for nutritional interventions for the management of inborn errors of metabolism. Mol Genet Metab 2013;109:319-28.

Lugner LK, Molleme L, Ruijs WLM, Hahne SJM. A cost utility analysis of antenatal screening to prevent congenital rubella syndrome. Epidemiol Infect 2010;138:1184.

Dhondt JL, Farriaux JP, Sailly JC, Lebrun T. Economic evaluation of cost-benefit ratio of neonatal screening procedure for phenylketonuria and hypothyroidism. J Inherit Metab Dis 1991;14:633-9.

Kasiri KA, Ganji F, Beigi R, Hashemi E. Evaluation of congenital hypothyroidism screening program in urban and rural health centers in Chaharamahal and Bakhtiari. J Shahrekord Univ Med Sci 2014;16:89-94.

Ramalho RJR, Valido DP, Aguiar-Oliveira MH. Avaliação do Programa de Triagem parao Hipotireoidismo Congênito no Estado de Sergipe. Arq Bras Endocrinol Metab 2000;44:157-61.

Ramalho RJ, Ramalho AR, Oliveira CR, Aguiar-Oliveira MH. Evolution of the screening program for congenital hypothyroidism and phenylketonuria in Sergipe State from 1995 to 2003. Arq Bras Endocrinol 2004;48:890-6.

Ramalho AR, Ramalho RJ, Oliveira CR, Santos EG, Oliveira MC, Aguiar-Oliveira MH. Neonatal screening program for congenital hypothyroidism in northeast of Brazil: criteria, diagnosis and results. Arq Bras Endocrinol 2008;52:617-27.

Souza CFM, Schwartz IV, Giugliani R. Neonatal screening of metabolic disorders. Ciênc Saúde Coletiva 2002;7:129-37.

Abadie V, Berthelot J, Feillet F, Maurin N, Mercier A, de Baulny HO, et al. Neonatal screening and long-term follow-up of phenylketonuria: the French database. Early Hum Dev 2001;65:149-58.

Williams RA, Mamotte CDS, Burnett JR. Phenylketonuria: an inborn error of phenylalanine metabolism. Clin Biochem Rev 2008;29:31-41.

Ramalho AR, Ramalho RJ, Oliveira CR, Magalhães MM, Santos EG, Sarmento PM, etal. Evaluation of effectiveness and outcome of PKU screening and management in the State of Sergipe, Brazil. Arq Bras Endocrinol 2014;58:62-7.

Loeber JG. Neonatal screening in Europe; the situation in 2004. J Inherit Metab Dis 2007;30:430-8.

Woolf LI. The high frequency of phenylketonuria in Ireland and western Scotland. J Inher Metab Dis 1978;1:101-3.

Liu Sr, Zuo Qh. Newborn screening for phenylketonuria in eleven districs. Chin med J (Engl) 1986;99:113-8.

Kaye CI, Committee on Genetics, Accurso F, La Franchi S, Lane PA, Hope N, et al. Newborn screening fact sheets. Pediatrics 2006;118:934-63.

Karamifar H, Ordoei M, Karamizadeh Z, Amirhakimi GH. Incidence of neonatal hyperphenylalaninemia in Fars Province,Southern Iran. Iran J Pediatr 2010;20:216-20.

Farhud DD, Kabiri M. Incidence of phenylketonuria in Iran. Indian J Pediatr 1982;49:685-8.

Golbahar J, Karamizadeh Z, Honardar Z. Selective screening of amino acid disorders in the south-west of Iran, Shiraz. J Inherit Metab Dis 2002;25:519-21.

Vela-Amieva M1, Ibarra-González I, Fernández-Lainez C, Monroy-Santoyo S, Guillén-López S, Belmont-Martínez L, et al. Cause of delay in referral of patients with phenylketonuria to a specialized reference center in mexico. J Med Screen 2011;18:115-20.

Brandalize SD, Czeresnia D. Evaluation of the program for prevention and health promotion in phenylketonuria patients in Brazil. Revista de Saúde Pública 2004;38:300-6.

Abadie V, Berthelot J, Feillet F, Maurin N, Mercier A, de Baulny HO, et al. Neonatal screening and long-term follow-up of phenylketonuria: the French database. Early Hum Dev 2001;65:149-58.

Holtzman C, Slazyk WE, Cordero JF, Hannon WH. Descriptive epidemiology of missed cases of phenylketonuria and congenital hypothyroidism. Pediatrics 1986;78:553-8.

Hanley WB, Demshar H, Preston MA, Borczyk A, Schoonheyt WE, Clarke JT, et al. Newborn phenylketonuria (PKU) Guthrie (BIA) screening and early hospital discharge. Early Hum Dev 1997;47:87-96.

Verkerk PH. 20-year national screening for phenylketonuria in The Netherlands. National Guidance Commission PKU. Nederl Tijdschr Geneesk 1995;139:2302-5.

Smith I, Cook B, Beasley M. Review of neonatal screening programme for phenylketonuria. BMJ 1991;303:333-5.

Senemar S, Ganjekarimi H, Fathzadeh M, Tarami B, Barzgar M. Epidemiological and clinical study of phenylketonouria (PKU) disease in the national screening program of neonates ,Fars Province, Southern Iran. Iranian J Publ Health 2009;38:58-64.

Habib A, Fallahzadeh MH, Kazeroni HR, Ganjkarimi AH. Incidence of Phenylketonuria in Southern Iran. Iran J Med Sci 2010;35:137-9.

Eshraghi P, Abaskhanian A, Mohammadhasani A. Characteristics of patients with phenylketonouria in Mazandaran Province, Northern, Iran. Casp J Int Med 2010;1:72-4.

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IssueVol 56, No 1 (2018) QRcode
SectionArticles
Keywords
Assessment Screening Phenylketonuria disease Phenylalanine

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How to Cite
1.
Ganji F, Naseri H, Rostampour N, Sedighi M, Lotfizadeh M. Assessing the Phenylketonuria Screening Program in Newborns, Iran 2015-2016. Acta Med Iran. 2018;56(1):49-55.