Abstract The ultramicroanalytic system (SUMA), created in the 1980s, is a complete system of
reagents and
instrumentation to perform ultramicroassays combining the
sensitivity of the micro-
enzyme-linked immunosorbent assay (
ELISA) tests with the use of ultramicrovolumes. This
technology permitted establishing large-scale
newborn screening programs (NSPs) for metabolic and endocrine disorders in
Cuba. This article summarizes the main results of the implementation during the 30 years of SUMA
technology in NSP for 5 inherited
metabolic diseases, using ultramicroassays developed at the Department of
Newborn Screening at the
Immunoassay Center. Since 1986, SUMA
technology has been used in the Cuban NSP for
congenital hypothyroidism, initially studying
thyroid hormone in cord
serum samples. In 2000, a decentralized program for the
detection of hyperphenylalaninemias using
heel dried
blood samples was initiated. These successful experiences permitted including
protocols for
screening congenital adrenal hyperplasia,
galactosemia, and
biotinidase deficiency in 2005. A program for the
newborn screening of CH using the
thyroid-stimulating hormone Neonatal ultramicro-
ELISA was fully implemented in 2010. Nowadays, the NSP is supported by a network of 175 SUMA
laboratories. After 30 years, more than 3.8 million Cuban
newborns have been screened, and 1002 affected
children have been detected. Moreover, SUMA
technology has been presented in
Latin America for over 2 decades and has contributed to screen around 17 million
newborns. These results prove that
developing countries can develop appropriate diagnostic
technologies for making
health care accessible to all.