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Project Launch: Philippine Critical Congenital Heart Disease Screening Project

Congenital heart disease occurs in 9 every 1,000 live births worldwide. Undetected, it can lead to approximately one quarter (2-3 out of 1,000) of these children developing CRITICAL CONGENITAL HEART DISEASE (CCHD), which requires surgery or catheter intervention in the first year of life.

Despite the increasing use of prenatal diagnosis and routine newborn examination, a significant proportion of affected newborns are still not diagnosed before discharge after birth. Since CCHD accounts for nearly 3% of infant mortality during the first year of life and affects between 7 and 9 of every 1,000 newborns, early detection can be life-saving and limit brain damage.

One way to detect early CCHD is PULSE OXIMETRY SCREENING (POS)—an effective, non-invasive, inexpensive tool. The American Academy of Pediatrics (AAP) recommends POS to be added to newborn screening (NBS). In fact, AAP has published strategies for the implementation of
pulse oximetry screening, which addressed critical issues such as necessary equipment, personnel, and training, and also provided specific recommendations for assessment of saturation by using pulse oximetry as well as appropriate management of a positive screening result.

In the Philippines, CCHD screening thru pulse oximetry is not yet a routine part of newborn care. There are currently no laws requiring CCHD screening prior to hospital discharge. However, several medical centers in Metro Manila have adopted this policy as part of their program based on published data abroad.

To address this lack, the Newborn Screening Reference Center (NSRC) of the UP Manila National Institutes of Health (UPM-NIH) has organized a group of hospitals to participate in a pilot study, entitled, “THE PHILIPPINE MULTICENTER PULSE OXIMETRY SCREENING FOR CRITICAL CONGENITAL HEART DISEASES.” It will run from March 2018 till the last week of February 2019.

The general aim of the study is to provide data on the utilization of POS as a screening tool in detecting neonates at risk of having critical congenital heart disease. Specifically, it will address three concerns: (1) To determine the prevalence of CCHD as confirmed by 2-dimensional echocardiography; (2) to specify the diagnosis of identified CCHD using 2-dimensional echocardiography; and, (3) to determine the outcome of neonates identified with CCHD. The provided data will be the basis of future policies on the inclusion of POS in the National Comprehensive Newborn Screening Policy.

The principal investigator is Dr. Jose Jonas Del Rosario. The co-investigators are Dr. Carmencita David-Padilla and Dr. Maria Melanie Liberty Alcausin. 

The list of the participating hospitals are: Baguio General Hospital and Medical Center, Cebu Maternity Hospital, Chinese General Hospital, East Avenue Medical Center, Jose Fabella Memorial Hospital, Philippine General Hospital, Quirino Memorial Medical Center, and Zamboanga City Medical Center.#

University of the Philippines Manila
National Institutes of Health
Newborn Screening Reference Center

Photos: VMendoza, MJTumulak


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