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Newborn Screening in the Philippines

An estimated 82000 of 2.4 million Filipino children die annually before their fifth birthday and half of the number occurring in newborns. Post-neonatal deaths may have decreased in number between 1990 and 2005, the number of neonatal mortalities did not births (National Statistics Office, 2009), with 21.6 deaths per 1,000 (Plecher, 2020) which is where the importance of newborn screening comes in. Newborn screening looks for any developmental, genetic and metabolic disorders in a newborn baby that could be potentially fatal or disabling conditions in newborns as early as possible, before the infant starts showing any signs of a disease or condition. It is usually done 48th hour or at least 24 hours from birth using the simple heel prick method where a few drops of blood are taken and blotted on a special absorbent filter card.

In the Philippines, the newborn screening program currently includes screening of six disorders: 

Congenital Hypothyroidism (CH)

This is the most common inborn metabolic disorder which is caused by the lack of thyroid hormone. This hormone is essential for the growth of the brain and the body.

Mental retardation and physical growth is delayed when not treated immediately.

Congenital Adrenal Hyperplasia (CAH)

This is a rare metabolic disorder that can cause salt loss, dehydration, and abnormally high male sex hormones  in both girls and boys.

This is dangerous as it can cause death within 7-14 days when not treated immediately.

Phenylketonuria (PKU)

This condition is characterized by the inability to properly use phenylalanine.

This can cause brain damage when excessive amounts of phenylalanine accumulates.

Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency

This is a condition which is characterized by the lack of the enzyme G6PD.

This results  in hemolytic anemia from exposure to oxidative substances.

Galactosemia (GAL)

This condition is characterized by the inability to process galactose in milk.

If excessive galactose accumulates in the body, problems such as liver damage, brain damage, and cataracts can occur.

Maple Syrup Urine Disease (MSUD)

This disease is due to the inability to process certain amino acids and is characterized by the sweet smell of the infant’s urine, hence the name

If untreated, this will lead to seizures, coma, and death.

Together with DOH-NIH, the Newborn Screening Reference Center (NSRC) assists by providing information and resources in the area of newborn screening to that can be useful to health professionals, the public health community, consumers and government officials in patenting programs and strategies with the ultimate goal of screening Filipino newborns for common life-threatening disorders. Recently, the expanded screening was recommended and will include 22 more disorders such as hemoglobinopathies and additional metabolic disorders, namely, organic acid, fatty acid oxidation, and amino acid disorders. Prices range from P550 for screening of six disorders and P1500 for the full complement of disorders (Suerte, 2013).  

With the help of expanded screening, more disorders can now be detected early hence saving the lives of more newborns and helping them ease possible negative health outcomes.

References:

MedlinePlus. (2020, August 18). Maple syrup urine disease: MedlinePlus Genetics.  Retrieved January 03, 2021, from https://medlineplus.gov/genetics/condition/maple-syrup-urine-disease/

National Statistics Office (NSO) [Philippines], ORC Macro. National Demographic and Health Survey 2008. Calverton, Maryland: NSO and ORC Macro, 2009.

Newborn Screening Reference Center. (n.d.). Retrieved January 03, 2021, from https://www.newbornscreening.ph/

Plecher, H. (2020). Philippines: Infant mortality rate in the Philippines 2019. Retrieved January 01, 2021, from https://www.statista.com/statistics/807110/infant-mortality-in-philippines/

Suerte, J. (2013). DOH approves expanded newborn screening program. Retrieved January 01, 2021, from http://www.pchrd.dost.gov.ph/index.php/news/r-d-updates/3137-doh-approves-expanded-newborn-screening-program.

Smart Parenting. (2009, December 21). Newborn Screening Explained: Why It's Important And What To Do. Retrieved January 03, 2021, from https://www.smartparenting.com.ph/parenting/baby/newborn-screening-explained-why-its-important-and-what-to-do

The Medical City. (n.d.). Newborn Screening. Retrieved January 03, 2021, from https://www.themedicalcity.com/news/newborn-screening