SCREENING PROGRAM PURPOSES

1. SCREENING PROGRAM PURPOSES A screening program serves one or more of the following purposes: • To avoid delay in diagnosis. • To prevent / minimize irreversible damage of a treatable disease. • To reduce exposure to harmful drugs or environment. • To educate parents on recurrence risks and provide counseling. • To provide premarital counseling.

2. EARLY DIAGNOSIS OF DISEASES • Premarital examination and screening • Comprehensive antenatal care • Screen of hereditary diseases during pregnancy • Neonatal screening programs • Age specific screening programs

3. ANTENATAL SCREENING METHODS • Maternal blood screening • Serial ultrasonography • Amniotic fluid analysis • Fetal blood analysis

4. METHODS OF PREVENTIVE HEALTH CARE • Improvements of general health and life style • Prevention of specific diseases • Screening for diseases with no apparent symptoms • Earl diagnosis of the diseases with symptoms and treatment • Rehabilitation of the affected persons

5. COMPONENTS OF NATIONAL NEONATAL SCREENING PROGRAM An integrated program for systematic detection and management of all patients affected by one of the disorders in the screening battery: • Education of the parents, the public and the practitioners about screening and about their participation in the activity. • Reliable acquisition and transportation of an adequate specimen. • Reliable and prompt performance of the screening test.

6. COMPONENTS OF NATIONAL NEONATAL SCREENING PROGRAM • Prompt retrieval and follow-up of individuals with abnormal screening tests. • Accurate diagnosis of individuals with positive confirmatory tests. • Education, genetic counseling, and psychosocial support for families with affected infants. • Appropriate medical management for patients. • A systematic outcome evaluation.

7. PUBLIC EDUCATION PROGRAMOBJECTIVES • To increase the basic knowledge and heighten the awareness of the general public. • Increase the basic knowledge of the professionals about the nature of the diseases screened and the benefits of the screening for treatment, • Prevention/minimization of the complications.

8. PUBLIC EDUCATION PROGRAMMETHODS-1 • Religious leaders since many Souras in the Holy Cora'an and Hadeethas well as traditional proverbs regarding prevention and careful planing for the future marriage will support the broad concept of screening. • Special TV programs and Radio talk shows. • Series of simplified articles in the news papers explaining the nature of the diseases, the need and benefits.

9. PUBLIC EDUCATION PROGRAM METHODS-2 • Educational pamphlets directed to the public. • Simplified lectures for the students in the High schools and the Universities. • Scientific medical seminars discussing various issues of screening.

10. SPECIALTY CLINICS RESPONSIBILITIES-1 Each of the subspecialty clinics should provide comprehensive services and follow up : • Clinical evaluation and confirmatory tests needed to reach final diagnosis. • Provides the necessary urgent and long term treatment if it is indicated. • Institutes prophylactic measures and preventive instructions to avoid complications.

11. SPECIALTY CLINICS RESPONSIBILITIES-2 • Provides education of parents by trained personnel using booklets or visual aids. • Evaluation of the efficacy of detection, management, and treatment which requires routine follow-up at regular intervals. • Develops protocols for management, evaluation and quality care improvement program.

12. COORDINATOR OF THE SCREENING PROGRAM RESPONSIBILITIES • Reviews the screening program policies and procedures and revises them if necessary. • Performs statistical analysis of the results. • Provides guidance to the physicians and nurses with regard to the program. • Initiates a quality assurance program. • Maintains the screening program manual; reviewing, revising and updating.

13. DISEASES TO BE SCREENED..? • Congenital Hypothyroidism • Hemoglobinopathies: Sickle Cell Diseases Ss, Sc, And Sb-Thalassemia, Alpha & beta Thalassmia, Hemoglobin H Dis. • Glucose-6-Phosphate Dehydrogenase Deficiency • Cystic Fibrosis • PKU

14. WHO SHOULD BE SCREENED ? • All newborns before the baby is discharged or transferred from the nursery, regardless of gestational age, birth weight, the nature or status of the infant's feeding or age. • Younger siblings of children previously diagnosed with one of the disorders on the screening panel. • Parents of an infant diagnosed as having G-6-PD deficiency or hemoglobinopathy. • Pre-marriage medical examination of men and women before marriage.

15. SCREENING PROCEDURES • The Specimen:An adequate specimen should be provided to the laboratory for analysis. Tube collection or dried filter paper specimen can be collected depending on the method which will be used by the laboratory. • Laboratory Results Reporting:The laboratory will provide a copy of the results to the following :1. Patient's file.2. Designated physician in each facility3. Newborn screening program coordinator for statistical analysis and the computer program.

16. SCREENING PROGRAM COMPUTER DATA BASEUtilization of the Data Base Program • On line record of the results available whenever it is needed. • Birth registry for all the newborns. • Facilitates periodic and final analysis for epidemiological and administrational analysis to Government Planing Authorities for health care facilities , social services and rehabilitation centers and education. • Development of Quality Control and Quality Improvement programs.