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Therrell BL, Padilla CD, Borrajo GJC, Khneisser I, Schielen PCJI, Knight-Madden J, Malherbe HL, Kase M. Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020-2023). Int J Neonatal Screen 2024; 10:38. [PMID: 38920845 PMCID: PMC11203842 DOI: 10.3390/ijns10020038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 03/28/2024] [Indexed: 06/27/2024] Open
Abstract
Newborn bloodspot screening (NBS) began in the early 1960s based on the work of Dr. Robert "Bob" Guthrie in Buffalo, NY, USA. His development of a screening test for phenylketonuria on blood absorbed onto a special filter paper and transported to a remote testing laboratory began it all. Expansion of NBS to large numbers of asymptomatic congenital conditions flourishes in many settings while it has not yet been realized in others. The need for NBS as an efficient and effective public health prevention strategy that contributes to lowered morbidity and mortality wherever it is sustained is well known in the medical field but not necessarily by political policy makers. Acknowledging the value of national NBS reports published in 2007, the authors collaborated to create a worldwide NBS update in 2015. In a continuing attempt to review the progress of NBS globally, and to move towards a more harmonized and equitable screening system, we have updated our 2015 report with information available at the beginning of 2024. Reports on sub-Saharan Africa and the Caribbean, missing in 2015, have been included. Tables popular in the previous report have been updated with an eye towards harmonized comparisons. To emphasize areas needing attention globally, we have used regional tables containing similar listings of conditions screened, numbers of screening laboratories, and time at which specimen collection is recommended. Discussions are limited to bloodspot screening.
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Affiliation(s)
- Bradford L. Therrell
- Department of Pediatrics, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA
- National Newborn Screening and Global Resource Center, Austin, TX 78759, USA
| | - Carmencita D. Padilla
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines;
| | - Gustavo J. C. Borrajo
- Detección de Errores Congénitos—Fundación Bioquímica Argentina, La Plata 1908, Argentina;
| | - Issam Khneisser
- Jacques LOISELET Genetic and Genomic Medical Center, Faculty of Medicine, Saint Joseph University, Beirut 1104 2020, Lebanon;
| | - Peter C. J. I. Schielen
- Office of the International Society for Neonatal Screening, Reigerskamp 273, 3607 HP Maarssen, The Netherlands;
| | - Jennifer Knight-Madden
- Caribbean Institute for Health Research—Sickle Cell Unit, The University of the West Indies, Mona, Kingston 7, Jamaica;
| | - Helen L. Malherbe
- Centre for Human Metabolomics, North-West University, Potchefstroom 2531, South Africa;
- Rare Diseases South Africa NPC, The Station Office, Bryanston, Sandton 2021, South Africa
| | - Marika Kase
- Strategic Initiatives Reproductive Health, Revvity, PL10, 10101 Turku, Finland;
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Hui LL, Nelson EAS, Deng HB, Leung TY, Ho CH, Chong JSC, Fung GPG, Hui J, Lam HS. The view of Hong Kong parents on secondary use of dried blood spots in newborn screening program. BMC Med Ethics 2022; 23:105. [PMID: 36319979 PMCID: PMC9628108 DOI: 10.1186/s12910-022-00839-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks.
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Affiliation(s)
- L L Hui
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.,Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - E A S Nelson
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - H B Deng
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - T Y Leung
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - C H Ho
- Academia Sinica, Taipei, Taiwan
| | - J S C Chong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - G P G Fung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - J Hui
- Private paediatrician, Hong Kong SAR, PR China
| | - H S Lam
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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IJzebrink A, van Dijk T, Franková V, Loeber G, Kožich V, Henneman L, Jansen M. Informing Parents about Newborn Screening: A European Comparison Study. Int J Neonatal Screen 2021; 7:ijns7010013. [PMID: 33652810 PMCID: PMC7930998 DOI: 10.3390/ijns7010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/19/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022] Open
Abstract
Knowledge about newborn screening (NBS) is an important factor for parents to make an informed decision about participation. In Europe, countries inform parents differently about their NBS program, potentially including different knowledge aspects in their information. The aim of this study was to assess twenty-six European parental information products and to analyze their knowledge aspects through a content analysis. The analyzed aspects were compared to a list of eight knowledge aspects from scientific literature. The list includes aspects important for parents' decision-making, such as the purpose of screening. The study showed that most of the eight knowledge aspects are included in NBS information products of the majority of countries. However, there were differences between countries, for example in the amount of detail and phrasing of the information. Additional relevant knowledge aspects have also been identified and are recommended to optimize information products, such as the handling of residual bloodspot samples. This study only assessed knowledge aspects in information products meant for printing, but many countries also use other communication methods, and the impact on knowledge of the delivery of the information needs further study. Preferences of parents on alternative communication methods need to be considered and evaluated on their effectiveness.
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Affiliation(s)
- Amber IJzebrink
- Department of Clinical Genetics, Section Community Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands; (A.IJ.); (T.v.D.); (L.H.)
| | - Tessa van Dijk
- Department of Clinical Genetics, Section Community Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands; (A.IJ.); (T.v.D.); (L.H.)
| | - Věra Franková
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital Praque, 128 08 Prague 2, Czech Republic; (V.F.); (V.K.)
- Institute for Medical Humanities, First Faculty of Medicine, Charles University Praque, 128 08 Praque 2, Czech Republic
| | - Gerard Loeber
- International Society for Neonatal Screening, 3721CK Bilthoven, The Netherlands;
| | - Viktor Kožich
- Department of Pediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital Praque, 128 08 Prague 2, Czech Republic; (V.F.); (V.K.)
| | - Lidewij Henneman
- Department of Clinical Genetics, Section Community Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands; (A.IJ.); (T.v.D.); (L.H.)
| | - Marleen Jansen
- Department of Clinical Genetics, Section Community Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, 1007 MB Amsterdam, The Netherlands; (A.IJ.); (T.v.D.); (L.H.)
- Centre for Health Protection, National Institue for Public Health and the Environment (RIVM), 3720 BA Bilthoven, The Netherlands
- Correspondence: ; Tel.: +31-20-444-3869
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Franková V, Driscoll RO, Jansen ME, Loeber JG, Kožich V, Bonham J, Borde P, Brincat I, Cheillan D, Dekkers E, Fingerhut R, Kuš IB, Girginoudis P, Groselj U, Hougaard D, Knapková M, la Marca G, Malniece I, Nanu MI, Nennstiel U, Olkhovych N, Oltarzewski M, Pettersen RD, Racz G, Reinson K, Salimbayeva D, Songailiene J, Vilarinho L, Vogazianos M, Zetterström RH, Zeyda M. Regulatory landscape of providing information on newborn screening to parents across Europe. Eur J Hum Genet 2020; 29:67-78. [PMID: 33040093 DOI: 10.1038/s41431-020-00716-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/06/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Abstract
Newborn screening (NBS) is an important part of public healthcare systems in many countries. The provision of information to parents about NBS is now recognised as an integral part of the screening process. Informing parents on all aspects of screening helps to achieve the benefits, promote trust and foster support for NBS. Therefore, policies and guidelines should exist to govern how the information about NBS is provided to parents, taking into account evidence-based best practices. The purpose of our survey was to explore whether any legally binding provisions, guidelines or recommendations existed pertaining to the provision of information about NBS to parents across Europe. Questions were designed to determine the regulatory process of when, by whom and how parents should be informed about screening. Twenty-seven countries participated in the survey. The results indicated that most countries had some sort of legal framework or guidelines for the provision of information to parents. However, only 37% indicated that the provision of information was required prenatally. The majority of countries were verbally informing parents with the aid of written materials postnatally, just prior to sample collection. Information was provided by a neonatologist, midwife or nurse. A website dedicated to NBS was available for 67% of countries and 89% had written materials about NBS for parents. The survey showed that there is a lack of harmonisation among European countries in the provision of information about NBS and emphasised the need for more comprehensive guidelines at the European level.
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Affiliation(s)
- Věra Franková
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic. .,Institute for Medical Humanities, Charles University First Faculty of Medicine, Prague, Czech Republic.
| | - Riona O Driscoll
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Marleen E Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - J Gerard Loeber
- International Society for Neonatal Screening Office, Bilthoven, The Netherlands
| | - Viktor Kožich
- Department of Paediatrics and Inherited Metabolic Disorders, Charles University First Faculty of Medicine and General University Hospital, Prague, Czech Republic.
| | - James Bonham
- Division of Pharmacy, Diagnostics and Genetics, Sheffield Children's NHS Foundation Trust, Sheffiled, UK
| | | | | | | | - Eugenie Dekkers
- RIVM Centre for Population Screening, Bilthoven, The Netherlands
| | | | | | | | - Urh Groselj
- UMC-University Children's Hospital, Ljubljana, Slovenia
| | | | - Mária Knapková
- Children's University Hospital, Banska Bystrica, Slovakia
| | | | | | - Michaela Iuliana Nanu
- National Health Programs Management Unit of National Institute for Mother & Child Health, Bucharest, Romania
| | - Uta Nennstiel
- Screening Center of the Bavarian Health and Food Safety Authority, Oberschleissheim, Germany
| | | | | | - Rolf D Pettersen
- Norwegian National Unit for Newborn Screening, Oslo University Hospital, Oslo, Norway
| | - Gabor Racz
- Department of Paediatrics, University of Szeged, Szeged, Hungary
| | | | - Damilya Salimbayeva
- Scientific centre of Gynaecology, Obstetrics and Perinatology, Almaty, Kazakhstan
| | | | - Laura Vilarinho
- National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | | | - Rolf H Zetterström
- Centre for inherited metabolic diseases, Karolinska University Hospital, Solna, Sweden
| | - Maximilian Zeyda
- Department of Paediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
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Abstract
PURPOSE OF REVIEW Exposomics studies can measure health-relevant chemical exposures during a lifetime and estimate the 'internal' environment. However, sampling limitations make these features difficult to capture directly during the critical neonatal time period. RECENT FINDINGS We review the use of newborn dried bloodspots (DBS) archived from newborn screening programs for exposomic analysis in epidemiological children's health studies. Emerging 'omics technologies such as adductomics and metabolomics have been adapted for DBS analysis, and these technologies can now provide valuable etiological information on the complex interplay between exposures, biological response, and population phenotypes. SUMMARY Adductomics and metabolomics of DBS can provide robust measurements for retrospective epidemiological investigations. With extensive bioarchiving programs in the United States and other countries, DBS are poised to substantially aid epidemiological studies, particularly for rare and low-frequency childhood diseases and disorders.
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