Incidencia de hipotiroidismo congénito en 14 regiones sanitarias del Paraguay

Abstract

Congenital hypothyroidism incidence in 14 sanitary regions of ParaguayCongenital hypothyroidism is one of the most common treatable causes of mental retardation, occurring in approximately 1 in 3,000 newborns. We investigated the incidence of congenital hypothyroidism in Paraguay, where iodine defi ciency disorders are considered endemic. Between October 1999 and February 2007, a total of 53,360 blood samples from 76 sampling stations in 14 of the country's 18 health regions were taken by heel prick and collected on fi lter paper. Screening was initially carried out as part of a pilot project and later as part of the program for prevention of cystic fi brosis and mental retardation. Thyroid-stimulating hormone was measured by the ELISA method, and a value of >20 UI/ml was considered the cutoff point for recall. Results were obtained in 96% (n: 52,526) of samples. Positive results were found in 0.08% (40/52,526) and congenital hypothyroidism was confi rmed in 35 cases, an incidence of 1 in 1,501 births, with a female to male ratio of 6:1. This incidence of congenital hypothyroidism is the highest yet reported in Latin America, a fact that emphasizes the importance of implementing this type of program in the fi ght to eliminate iodine defi ciency disorders. (

Neonatal Screening for Congenital Hypothyroidism in Nicaragua: Audit of a Cord-blood Thyrotropin-based Program (2005-2015)

“…The PPV of the program is 83% a figure close to those of the CH programs in Mexico (75%) [25], Paraguay (87%) [34] and Argentina (88%) [35]. The FP was 16.7%.…”

Consolidation of the Neonatal Screening Program as a Public Health Program in Paraguay

“…Weaknesses include the age of diagnosis and initiation of treatment, mainly associated with the delay in locating positive cases after screening and in CF the diagnostic sweat test performed once a month. However, an improvement is seen with respect to what was published in the first decade of the program in relation to CH, with the average age at start of treatment being 50 days [35]. We should continue monitoring until treatment is started before two weeks [36], considering the high incidence of this pathology, as well as others such as the rejection of samples either by nonelution or insufficiency, being a strategy the continuous training of health professionals, if possible, included as an undergraduate subject in public health careers.…”

“…The incidence of the pathologies detected is similar to what is described in other countries in the region. It is important to point out the proportion of the female over the male gender that is prevalent in CH, being 3:1, this has already been reported [35,[37][38][39].…”

Principios de la bioética comprometidos en la detección neonatal

“…La implementación del programa ha implicado la capacitación a los profesionales de salud, así como la difusión de este estudio en la comunidad. El programa ofrece el diagnóstico y tratamiento gratuitos de manera masiva para el hipotiroidismo congénito y la fenilcetonuria, no así para la fibrosis quística, que son ofrecidos selectivamente ante la presencia de síntomas en el periodo neonatal o antecedentes familiares (8). A continuación, describimos: 1) Los principios de la bioética que podrían verse involucrados en mayor o menor medida en la detección neonatal; 2) Los principales protagonistas así como los espacios involucrados en la realización del proceso de detección neonatal, incluyendo algunas breves nociones sobre este procedimiento, dirigidas en especial al lector inexperto en el tema y necesarias para la comprensión del trabajo…”