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Padilla CD, Therrell BL, Alcausin MMLB, de Castro RC, Gepte MBP, Reyes MEL, Jomento CM, Suarez RCN, Maceda EBG, Abarquez CG, Posecion JEWC, Andal AP, Elizaga ALG, Halili-Mendoza BC, Otayza MPVK, Hoppe CC. Successful Implementation of Newborn Screening for Hemoglobin Disorders in the Philippines. Int J Neonatal Screen 2021; 7:30. [PMID: 34204320 PMCID: PMC8293152 DOI: 10.3390/ijns7020030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/17/2022] Open
Abstract
The Philippine newborn bloodspot screening (NBS) program began in 1996 with 24 hospitals and was formalized by legislation in 2004. The NBS panel was recently expanded to include a number of additional hereditary congenital conditions. Expertise and experiences from other NBS programs already screening for hemoglobinopathies were essential to its successful integration into the ongoing dried bloodspot NBS program in the Philippines. Building on clinical experiences and population data from Filipinos born in California, USA, hemoglobinopathies (including thalassemias) were selected for inclusion in the expanded screening panel. Hemoglobinopathy NBS, using high performance liquid chromatography, was implemented in a stepwise manner into the seven regional NBS screening laboratories. A central university laboratory provides confirmatory testing using both capillary electrophoresis and molecular methodologies. NBS results indicating carriers are followed up with educational fact sheets, while results of presumptive disease are referred for confirmatory testing and follow-up with a hematologist. Long-term care is provided through newborn screening continuity clinics across the country. Hemoglobinopathy NBS is now included in the national insurance package and screening uptake continues to increase nationally, exceeding 90% of all newborns in 7400+ hospitals and birthing centers nationwide prior to the COVID-19 pandemic.
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Affiliation(s)
- Carmencita D. Padilla
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Bradford L. Therrell
- National Newborn Screening and Global Resource Center, Austin, TX 78759, USA;
- University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Maria Melanie Liberty B. Alcausin
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
- Department of Pediatrics, College of Medicine, University of the Philippines Manila, Manila 1000, Philippines
| | - Reynaldo C. de Castro
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Maria Beatriz P. Gepte
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Ma. Elouisa L. Reyes
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Charity M. Jomento
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Riza Concordia N. Suarez
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Ebner Bon G. Maceda
- Newborn Screening Reference Center, National Institutes of Health, University of the Philippines Manila, Manila 1000, Philippines; (M.M.L.B.A.); (R.C.d.C.J.); (M.B.P.G.); (M.E.L.R.); (C.M.J.); (R.C.N.S.); (E.B.G.M.)
| | - Conchita G. Abarquez
- Newborn Screening Center—Mindanao, Southern Philippine Medical Center, Davao 8000, Philippines;
| | | | - Alma P. Andal
- Newborn Screening Center—Southern Luzon, Daniel O. Mercado Medical Center, Tanauan City 4232, Philippines;
| | - Anna Lea G. Elizaga
- Newborn Screening Center—National Institutes of Health, Quezon City 1101, Philippines;
| | - Bernadette C. Halili-Mendoza
- Newborn Screening Center—Central Luzon, Angeles City University Foundation Medical Center, Angeles City 2009, Philippines;
| | - Maria Paz Virginia K. Otayza
- Newborn Center—Northern Luzon, Mariano Marcos Memorial Hospital and Medical Center, Batac City 2906, Philippines;
| | - Carolyn C. Hoppe
- UCSF Benioff Children’s Hospital Oakland, Oakland, CA 94609, USA;
- Global Blood Therapeutics, Inc., South San Francisco, CA 94080, USA
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Khongthai K, Ruengdit C, Panyasai S, Pornprasert S. Analysis of Deletional Hb H Diseases in Samples with Hb A2-Hb H and Hb A2-Hb Bart’s on Capillary Electrophoresis. Hemoglobin 2019; 43:245-248. [DOI: 10.1080/03630269.2019.1683573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kunyakan Khongthai
- Laboratory Department, Chiang Mai Health Promoting Hospital, Chiang Mai, Thailand
| | - Chedtapak Ruengdit
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sakorn Pornprasert
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
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Newborn Screening for Sickle Cell Disease and Other Hemoglobinopathies: A Short Review on Classical Laboratory Methods-Isoelectric Focusing, HPLC, and Capillary Electrophoresis. Int J Neonatal Screen 2018; 4:39. [PMID: 33072959 PMCID: PMC7548892 DOI: 10.3390/ijns4040039] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 11/01/2018] [Indexed: 12/04/2022] Open
Abstract
Sickle cell disease (SCD) and other hemoglobinopathies are a major health concern with a high burden of disease worldwide. Since the implementation of newborn screening (NBS) for SCD and other hemoglobinopathies in several regions of the world, technical progress of laboratory methods was achieved. This short review aims to summarize the current practice of classical laboratory methods for the detection of SCD and other hemoglobinopathies. This includes the newborn screening technologies of high-performance liquid chromatography (HPLC), capillary electrophoresis (CE), and isoelectric focusing (IEF).
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Jiang F, Chen GL, Li J, Xie XM, Zhou JY, Liao C, Li DZ. Pre Gestational Thalassemia Screening in Mainland China: The First Two Years of a Preventive Program. Hemoglobin 2017; 41:248-253. [DOI: 10.1080/03630269.2017.1378672] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Fan Jiang
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Gui-Lan Chen
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jian Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Xing-Mei Xie
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Jian-Ying Zhou
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Can Liao
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
| | - Dong-Zhi Li
- Prenatal Diagnostic Center, Guangzhou Women and Children’s Medical Center, Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China
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Greene DN, Vaughn CP, Crews BO, Agarwal AM. Advances in detection of hemoglobinopathies. Clin Chim Acta 2014; 439:50-7. [PMID: 25314938 DOI: 10.1016/j.cca.2014.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 10/04/2014] [Accepted: 10/04/2014] [Indexed: 01/19/2023]
Abstract
Hemoglobin disorders are recognized as one of the most common inherited diseases worldwide. Detecting and characterizing variant hemoglobins and thalassemias depends primarily on clinical laboratory methods. Multiple biophysical, biochemical, and genetic assays are available to provide phenotypic or genotypic evidence of pathology. For many years conventional slab-gel electrophoresis and HPLC were the most commonly utilized laboratory methods. However, the field has rapidly expanded to regularly include capillary zone electrophoresis, molecular assays, and, more recently, mass spectrometric assays. Interpretation of these techniques is, in general, complicated because of the involvement of multiple polymorphic genes. Proper characterization of hemoglobin variants is necessary for diagnosis, primary prevention and genetic counseling for underlying disorders. This review provides an overview of the current hemoglobin analysis techniques, and also discusses technologies that have potential to translate into widespread clinical settings.
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Affiliation(s)
- Dina N Greene
- TPMG, Northern California Kaiser Permanente Regional Laboratories, Berkeley, CA, United States.
| | - Cecily P Vaughn
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, United States
| | - Bridgit O Crews
- TPMG, Northern California Kaiser Permanente Regional Laboratories, Berkeley, CA, United States
| | - Archana M Agarwal
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, United States; Department of Pathology, University of Utah Health Sciences, Salt Lake City, UT, United States
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