Newborn screening: experience of Bangladesh.

Newborn screening for early diagnosis of many preventable diseases is already an established program in developed countries as well as in some countries in Asia. With the control of infectious and communicable diseases, the Bangladesh government is now giving more attention to the preventive aspect of health. The country is now preparing to adopt newborn screening as part of the preventive aspect of health. Among the various activities are laboratory set up, expert visits, pilot studies on CH and training of personnel. A national project to screen newborns for congenital hypothyroidism is now under active consideration. A universal newborn screening program is a highly ambitious project for a country like Bangladesh. Funds to run such a program will be the main problem. The social pattern where still more than 80% of deliveries are done at home is another constraint. However, the enthusiasm of the professionals as well as of the government is a very encouraging thing. Now it needs the support of the international communities.

Screening for congenital hypothyroidism--a new era in Bangladesh.

Neonatal screening is a new concept in Bangladesh. Currently a pilot program is ongoing where newborns are screened for congenital hypothyroidism (CH). In a country like Bangladesh, where people are still fighting childhood problems like malnutrition, diarrhea and other communicable diseases with a high infant and child mortality rate, instituting a newborn screening program is a challenge. TSH is measured on filter paper using IRMA methods. Both cord and heel prick blood are used. A cut off value of 20 mIU/l is used above which all babies are recalled for serum T4 evaluation. Approximately 2600 newborns have been screened in the pilot program. Of these, 2 newborns were detected with CH (incidence rate 1:1300). Since it is a new program in Bangladesh, effort is mainly given on popularizing the program and building necessary infra-structure. The newborn screening program has been accepted with mixed reaction in the community. Hopefully, the government is developing a positive attitude towards the program. The paediatricians and obstetricians are also interested. The program needs more publicity. Patronization by the government and other international bodies will be essential for continuation of the program.