Congenital Hypothyroidism Among Palestinian Children of The West Bank

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Date
2001
Authors
Issa Ibrahim Ishtieh
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Neonaial initiated in the west bank in 1990 the aim of this study was to establish a base line data regarding CH Incidence and to determine possible risk factors This study show that the screening program system faced many inherited obstacles regarding sampling. as Well as handlings of specimens. and also in the follow up of results and communicating results to concerned people. From October 1998 to May 2000 there were 85.149 live births. Around (69.9:57) neonates were screened using a primary measurement of TSH in capillary blood, using dried blood spots obtained by a heel prick. All samples were assayed by immunoassay method. 'thirty-two cases were diagnosed as suspected permanent CI I ( incidence, I :2186.15). This incidence is notably higher that reported in most other countries. The etiology of this high incidence is unknown, however, it seems to be of a multifactorial .form. Although our result point that parental consanguinity may play a significant part on the frequency of CH in our population, environmental factors cannot be excluded. Recall rate was found to be (0.78%). The incidence of transitory hypothyroidism remarkably high (1: 418.9). About 14.96 % of infants screened were with raised TSH level of 5 RIU/ml. Thus, neonatal screening seems to be highly affected by iodine deficiency' leading to increased recall rates, transient and permanent cases of CH. Although our screening program have benefited patients and families to some extent, it seems that it does not reached it's main objectives which are, early detection and therapy. Screening and confirmatory thyroid function results revealed moderate to Severe abnormalities, with information delay in screening screening (89 days), diagnosis (143 days) and treatment(152 days) Observations on severity of disease symptoms, growth and development problems were significantly correlated with delay in therapy. this fact supports the view that a comprehensive program has to be initiated. Thus, it seems reasonable to strive for early detection and management [Or effective prognosis. lo achieve this goal, cooperation between all primary health care providers, to the infant from conception to birth, is definitely needed.
Neonaial initiated in the west bank in 1990 the aim of this study was to establish a base line data regarding CH Incidence and to determine possible risk factors This study show that the screening program system faced many inherited obstacles regarding sampling. as Well as handlings of specimens. and also in the follow up of results and communicating results to concerned people. From October 1998 to May 2000 there were 85.149 live births. Around (69.9:57) neonates were screened using a primary measurement of TSH in capillary blood, using dried blood spots obtained by a heel prick. All samples were assayed by immunoassay method. 'thirty-two cases were diagnosed as suspected permanent CI I ( incidence, I :2186.15). This incidence is notably higher that reported in most other countries. The etiology of this high incidence is unknown, however, it seems to be of a multifactorial .form. Although our result point that parental consanguinity may play a significant part on the frequency of CH in our population, environmental factors cannot be excluded. Recall rate was found to be (0.78%). The incidence of transitory hypothyroidism remarkably high (1: 418.9). About 14.96 % of infants screened were with raised TSH level of 5 RIU/ml. Thus, neonatal screening seems to be highly affected by iodine deficiency' leading to increased recall rates, transient and permanent cases of CH. Although our screening program have benefited patients and families to some extent, it seems that it does not reached it's main objectives which are, early detection and therapy. Screening and confirmatory thyroid function results revealed moderate to Severe abnormalities, with information delay in screening screening (89 days), diagnosis (143 days) and treatment(152 days) Observations on severity of disease symptoms, growth and development problems were significantly correlated with delay in therapy. this fact supports the view that a comprehensive program has to be initiated. Thus, it seems reasonable to strive for early detection and management [Or effective prognosis. lo achieve this goal, cooperation between all primary health care providers, to the infant from conception to birth, is definitely needed.
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