Screening Center Research Articles

Knowledge, Attitude, and Prevalence Towards Cervical Cancer Screening Among Women in a Nigerian Urban Municipality

BACKGROUND: Cervical cancer is a significant global health concern, particularly in less developed regions, ranking as the fourth most common cancer among women. Nigeria faces its crisis, with approximately 15,000 women diagnosed annually, resulting in a two-thirds fatality rate. An alarming 40 million Nigerian women remain at risk, underscoring the urgency of improved screening and disease surveillance, compounded by the absence of a national cancer policy and limited awareness. Cervical cancer can be reduced by more than 90% through regular screening. It is caused by sexually transmitted HPV and risk factors include multiple sexual partners, smoking, long-term oral contraceptive use, and immunosuppression. AIM: The study aimed to ascertain the knowledge, attitude, and practices toward cervical cancer screening and the factors that influence the practice of screening among women of the reproductive age group in Calabar Municipality. METHODS: Using a cross-sectional study design, 414 women were enrolled from two public hospitals, four private hospitals, and a non-governmental women’s center through a meticulous multi-stage sampling technique, employing semi-structured questionnaires. Socio-demographic variables were collected, and a 31-item questionnaire was used to assess the level of knowledge, attitudes, and practices toward cervical cancer. Data were analyzed using IBM SPSS version 26; p-values less than 0.05 were considered significant. RESULTS: The mean ages of respondents were 28.01 ± ((8.8357), 293 were single, while 107 were married. 69.67% had received at least tertiary education. 51.9% were employed, and the rest were unemployed. All 414 respondents were familiar with cervical cancer, but 65.7% lacked adequate knowledge of screening. Approximately 60% were aware of screening tests, with health workers as their primary information source. Most women displayed a favorable attitude toward screening; 97.3% expressed willingness if the procedure was explained and accessible, 96.4% if it was free and safe, and 97.6% supported screening for women under 30 years. Unfortunately, only 8% had undergone screening, with Pap smears as the commonest screening method for 84.8% of those who had received screening. Out of 381 respondents who had never been screened, 101 did not think they were at risk, 89 did not know where to get screened, 75 believed their religion protected them, and 37 found it expensive. In bivariate analysis, age, marital status, employment status, and knowledge of screening significantly correlated with good practice (p<0.05). CONCLUSION: The underutilization of screening services in an urban setting is concerning, signaling the potential for cancer care disparities in rural areas. Urgent interventions are needed to foster more favorable attitudes and practices, particularly in developing countries like Nigeria, where cervical cancer remains a leading women's health concern. With Nigeria's limited healthcare financing and fragile health system, cervical cancer screening promotion is crucial. Community-based strategies should be utilized to promote screening, and medical outreaches organized to eliminate healthcare barriers. The government should increase funding for the health sector and provide more screening centers while empowering healthcare providers.

Development and quality appraisal of a new English breast screening linked data set as part of the age, test threshold, and frequency of mammography screening (ATHENA-M) study.

To build a data set capturing the whole breast cancer screening journey from individual breast cancer screening records to outcomes and assess data quality. Routine screening records (invitation, attendance, test results) from all 79 English NHS breast screening centres between January 1, 1988 and March 31, 2018 were linked to cancer registry (cancer characteristics and treatment) and national mortality data. Data quality was assessed using comparability, validity, timeliness, and completeness. Screening records were extracted from 76/79 English breast screening centres, 3/79 were not possible due to software issues. Data linkage was successful from 1997 after introduction of a universal identifier for women (NHS number). Prior to 1997 outcome data are incomplete due to linkage issues, reducing validity. Between January 1, 1997 and March 31, 2018, a total of 11 262 730 women were offered screening of whom 9 371 973 attended at least one appointment, with 139 million person-years of follow-up (a median of 12.4 person years for each woman included) with 73 810 breast cancer deaths and 1 111 139 any-cause deaths. Comparability to reference data sets and internal validity were demonstrated. Data completeness was high for core screening variables (>99%) and main cancer outcomes (>95%). The ATHENA-M project has created a large high-quality and representative data set of individual women's screening trajectories and outcomes in England from 1997 to 2018, data before 1997 are lower quality. This is the most complete data set of English breast screening records and outcomes constructed to date, which can be used to evaluate and optimize screening.

Assessment of the Iraqi Breast Cancer Early Detection and Downstaging Program: Mammography Cancer Detection Rate

Background: In Iraq, early detection and downstaging of breast cancer programs were launched to control breast cancer (BC) in 2000. In the program model, mammography is conducted for normal and symptomatic women. The aim of this study is to assess the program’s model effectiveness in terms of mammography cancer detection rates and other screening determinates in the Iraqi Early Detection Program. Method: This is a retrospective study based on data attained from the Breast Disease Treatment Centre (BDTC) in Sulaimani, Iraq. From September 2016 to August 2021, 35,045 women visited the centre for BC screening and diagnosis of breast disorders. In BDTC, 16,186 mammograms and 1,289 biopsies were conducted, and 404 women were diagnosed with BC. This study measured the percentage of women who visited BDTC for screening, the women’s ages at diagnosis, the cancer detection rate (BC per 1,000 women visiting), mammography detection rate (BC per 1,000 mammograms) and the percentage of positive core biopsies. Results: The cancer detection rate (CDR) in 1,000 women was 11.53, the overall mammography detection rate was 24.96, and the highest rate was observed in 2018 (42.2). The overall percentage of positive core biopsies was 31.34%. The highest percentage biopsy rate was in 2017 (43.84%). From 2016 to 2021, the percentage of visits for screening increased gradually, rising from 9.5% to 28.6%. Conclusion: The early detection program in Iraq is considered to be effective in terms of high mammography cancer detection rates and the percentage of positive biopsy. Compared to the previous data, more women participated in the program for screening than for diagnosis.

Long-term follow-up of children with carbamoyl phosphate synthase 1 deficiency detected in newborn screening.

To investigate genotype-phenotype characteristics and long-term prognosis of neonatal carbamoyl phosphate synthetase 1 (CPS1) deficiency among children through newborn screening in Zhejiang province. The clinical and follow-up data of children with CPS1 deficiency detected through neonatal screening and confirmed by tandem mass spectrometry and genetic testing in Zhejiang Province Newborn Disease Screening Center from September 2013 to August 2023 were retrospectively analyzed. A total of 4 056 755 newborns were screened and 6 cases of CPS1 deficiency were diagnosed through phenotypic and genetic testing. Ten different variations of CPS1 genewere identified in genetic testing, including 2 known pathogenic variations (c.2359C>T and c.1549+1G>T) and 8 unreported variations (c.3405-1G>T, c.2372C>T, c.1436C>T, c.2228T>C, c.2441G>A, c.3031G>A, c.3075T>C and c.390-403del). All patients had decreased citrulline levels (2.72-6.21 μmol/L), and varying degrees of elevated blood ammonia. The patients received restricted natural protein intake (special formula), arginine and supportive therapy after diagnosis, and were followed-up for a period ranging from 9 months to 10 years. Three patients experienced hyperammonemia, and one patient each had attention deficit hyperactivity disorder, transient facial twitching and increased muscle tone. One patient died, while the other five surviving patients had normal scores of the Ages & Stages Questionnaires (ASQ) and Griffiths Development Scales up to the present time; 4 cases had combined height or weight lag and one case was normal in height and weight. Low citrulline levels and hyperammonemia are common in CPS1 deficiency patients in Zhejiang. Most gene variants identified were specific to individual families, and no hotspot mutations were found. Early diagnosis through newborn screening and following standardized treatment can significantly improve the prognosis of the patients.

Abstract C112: Improving breast cancer screening disparities through A3 problem solving: Design of a quality improvement initiative

Abstract Introduction: Extensive research studies on breast cancer disparities have had limited impact on reducing breast cancer disparities. Quality improvement initiatives use data-driven, rigorous approaches to plan, execute, and study the delivery of healthcare services. There have been limited studies using quality improvement methods to address health disparities. The purpose of our study was to describe the design of a quality improvement initiative to address breast cancer disparities using the A3 problem solving method. Methods: A3 problem solving method was used to reduce breast cancer screening disparities. The A3 method is a quality improvement tool used to identify problems, organize and synthesize data, and propose solutions to achieve goals (summarized on one side of a sheet of paper). A3 methods are outlined by the FOCUS-PDCA acronym: F - Find process to improve, O - Organize team of stakeholders, C - Clarify current state, U - Understand sources of variation that contribute to the problem, S - Select change ideas, P - Plan and do the improvement, C - Check the results, A - Act. Quantitative data was derived from the electronic medical record. Qualitative data was derived from divergent thinking exercises asking participants from diverse standing urban stakeholder groups about barriers to cancer screening. Results: Design of the A3 problem solving process was conducted between November 2022 until May 2023 yielding the following FOCUS-PDCA design and initial results. F - Increase the percentage of patients who have undergone mammography screening within the last two years. O - Team includes representative leaders from primary care, community health, ambulatory operations, diversity, equity, and inclusion, radiology, breast center, population health, information services, and federally qualified health centers. C and U - Quantitative data collection revealed that 74% of 37,509 eligible patients (women between 50-74 years old) received a mammogram within the last two years (75% White, 58% Black, 67% Asian, 60% American Indian, 64% Hispanic). Divergent thinking exercises revealed the following root causes for mammography screening disparities: patients don’t know they are due, transportation issues, barriers to scheduling, access to mammography facilities, financial concerns, and fears about returning to clinics during COVID-19. S - Process improvements included multilingual and modality reminders, marketing campaigns, transportation vouchers, co-location of screening centers with federally qualified health centers, expanded access to mammography screening facilities, educational activities for primary care physicians, participation in community events, equity-focused review of screening guidelines. PDCA - Based on selected improvements, changes in breast cancer screening percentages will be displayed using run charts until December 2024, stratified by race and ethnicity. Conclusion: A3 problem solving tools represent structured, scientifically rigorous approaches that cancer centers can use to reduce screening disparities. Citation Format: Nia Foster, Arissa J. Milton, Mai A. Elezaby, Roberta M. Strigel, Meeghan A. Lautner, Ryan W. Woods, Nicci O. Brackett, Noelle K. LoConte, Anand K. Narayan. Improving breast cancer screening disparities through A3 problem solving: Design of a quality improvement initiative [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C112.

Affective State and Corresponding Psychophysiological Findings of Healthcare Workers in Coronavirus Disease of 2019 Screening Centers

Affective State and Corresponding Psychophysiological Findings of Healthcare Workers in Coronavirus Disease of 2019 Screening Centers

Guiding gaze gestures on smartwatches: Introducing fireworks

Smartwatches enable interaction anytime and anywhere, with both digital and augmented physical objects. However, situations with busy hands can prevent user inputs. To address this limitation, we propose Fireworks, an innovative hands-free alternative that empowers smartwatch users to trigger commands effortlessly through intuitive gaze gestures by providing post-activation guidance. Fireworks allows command activation by guiding users to follow targets moving from the screen center to the edge, mimicking real life fireworks. We present the experimental design and evaluation of two Fireworks instances. The first design employs temporal parallelization, displaying few dynamic targets during microinteractions (e.g., snoozing a notification while cooking). The second design sequentially displays targets to support more commands (e.g., 20 commands), ideal for various scenarios other than microinteractions (e.g., turn on lights in a smart home). Results show that Fireworks’ single straight gestures enable faster and more accurate command selection compared to state-of-the-art baselines, namely Orbits and Stroke. Additionally, participants expressed a clear preference for Fireworks’ original visual guidance.

Spatial access to screening centers and late-stage lung cancer in Alabama.

130 Background: Cancer stage at diagnosis has a tremendous influence on type of treatment, recovery and survival. This study examined the impact of spatial access to healthcare services on late-stage lung cancer diagnosis in Alabama, taking into account access and travel time to the nearest Screening Center of Excellence (SCOE). Methods: A cross-sectional retrospective study of lung cancer incidence in the state of Alabama was employed, using zipcode as unit of analysis. Data on individual lung cancer diagnosis between 2013 and 2018 was obtained from Alabama State Cancer Registry. Geographic information system (GIS) network analysis was used to calculate distance to the nearest SCOE. Descriptive statistics were used to compare distribution of independent variables including residential status, age, race, gender and insurance across lung cancer diagnosis stage. Multi-variable logistic regression assessed odds ratio and 95% confidence intervals to evaluate the relationship between residential status and late-stage diagnosis. Results: 14,556 individuals were diagnosed with lung cancer in Alabama from 2013 - 2018. Late-stage diagnosis accounted for 72.7% of cases, predominantly among males (56.5%) and Whites (79.8%). Late-stage vs. early-stage cases differed significantly in sex (males: 59.2% vs. 50.9%) and race (Whites: 78.6% vs. 83.4%) (p < 0.0001). Multivariable logistic regression analyses found that Alabamians were more likely to be diagnosed with late stage lung cancer if they were Black (p < 0.0001); male (p < 0.0001); uninsured (p < 0.0001); and/or insured via Medicaid (p < 0.0001). Alabamians were less likely to be diagnosed with late stage lung cancer if they were within 60 miles of a SCOE (p < 0.0001). Living in a persistent poverty census tract was associated with a lower OR for late-stage lung cancer occurrence (adjusted OR = 0.88, 95% CI =0.78-0.99, p=0.0341). Neighborhood Deprivation Index did not significantly correlate with late-stage lung cancer (p = 0.8280). Conclusions: Proximity to screening centers within 60 miles is associated with a reduced likelihood of late-stage lung cancer. Additionally, race, sex, insurance status, and age are significant factors. These findings underscore the importance of access to screening centers and the influence of demographic and socioeconomic factors on lung cancer stage at diagnosis.

Association of Blood Trace Elements Levels with Cardiovascular Disease in US Adults: a Cross-Sectional Study from the National Health and Nutrition Examination Survey 2011-2016.

We aimed to explore the overall association between trace elements and cardiovascular disease (CVD) and its types in humans. A total of 5101 participants' blood samples from the 2011-2016 National Health and Nutrition Examination Survey were included. Biochemical data were collected from laboratory tests conducted at mobile screening centers. After assessing linearity, weighted logistic regression estimated the association between trace elements and various CVD types. Weighted quantile sum (WQS) regression and quantile-based g-computation (Qgcomp) evaluated the overall relationship between biological trace elements and CVD types. After fully adjusting for confounding factors, the odds ratios of overall CVD morbidity corresponding to the second, third, and fourth quartiles of higher selenium (Se) concentration were 0.711 (95% CI, 0.529-0.956, p = 0.024), 0.734 (95% CI, 0.546-0.987, p = 0.041), and 0.738 (95% CI, 0.554-0.983, p = 0.038), respectively. Moreover, an increase in the concentration of copper (Cu) was associated with an increased risk of stroke (95% CI, 1.012-1.094, p = 0.01), heart failure (95% CI, 1.001-1.095, p = 0.046), and heart attack (95% CI, 1.001-1.083, p = 0.046). As the concentration of trace elements in the body increased, there was a significant positive association between Cu and CVD prevalence. On the other hand, Se and zinc were negatively associated with CVD prevalence. A nonlinear relationship between Se and CVD was found, and an appropriate Se intake may reduce the risk of CVD. Cu levels positively correlated with CVD risk. However, prospective cohort studies are warranted to confirm the causal effects of the micronutrients on CVD and its types.

Towards SDG30: Fighting HCV with a screening program in Lombardy

Abstract Background The third Sustainable Development Goal, specifically in target 3.3, identifies fighting HCV as a priority. It is estimated that in Italy more than 200.000 patients eligible for HCV treatment are not being treated and 20% are not aware of the infection. Lombardy region to promptly identify and treat patients affected, developed a screening program to be offered to all patients born between 1969 and 1989. Healthcare facilities were divided into first and second-level centers and the campaign was designed in 2 phases: at the first level centres patients were screened with blood tests, if positive they were contacted by second level structures to get a diagnostic test and if confirmed positive to start the therapeutic approach. Methods The screening program started in June 2022 and consisted of an opportunistic offer of free testing for serum anti-HCV antibodies in the context of any healthcare performance offered to eligible patients. Data were uploaded and collected on a web database from which second-level centers could obtain data of positive patients to contact them and set appointment for confirmation tests. Results As of 31st December 2022 120,193 individuals underwent HCV screening in 75 screening centers in Lombardy. The mean age was 44 years, 65.2% were females, and 83.7% were tested at outpatient blood collection centers. 604 (0.50%) patients tested positive with mean age 47 (±5). HCV-RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects with available HCV-RNA. Patients with active HCV infection were aged 46 (±6) and were mostly males (56.8%). Overall, the prevalence of active infection in the general population was 0.10% and was higher in elderly. Conclusions The prevalence of active HCV infection in the general population born between 1969 and 1989 in Lombardy was low. Considering the higher prevalence of active infection in the elderly population, an extension of the screening offer to patients born between 1949-70 could be evaluated. Key messages • Prevalence of active HCV infection in screened population is low. • Extending the screening offer may result in higher number of positive results and more people directed towards treatment.

Universal Newborn Hearing Screening Program: 10-Year Outcome and Follow-Up from a Screening Center in Germany.

Regular reporting of quality control is important in newborn hearing screening, ensuring early diagnosis and intervention. This study reports on a population-based newborn hearing screening program in North-Rhine, Germany and a hospital-based screening at a University Hospital for 2007-2016. The two-staged 'screening' and 'follow-up' program involving TEOAE and AABR recruited newborns through participating birth facilities. Results were sent to the regional tracking center, and the data were analyzed based on recommended benchmarks. The percentage of newborns from the participating birth facilities in the region increased from 1.4% in 2007 to 57.5% in 2016. The 10-year coverage rate for these newborns was 98.7%, the referral rate after a failed two-step screening was 3.4%, and the lost-to-follow-up rate was 1%. At the hospital, >95% of the screened newborns completed screening within 30 days, the 10-year referral rate was 5%, and 64% were referred within 3 months of age. The median time for screening completion was 6 days after birth, for referral it was 74 days after birth, and for diagnosis it was 55 days after birth. Regional-centralized tracking centers with uniform structure are necessary for proper quality control. Obligatory participation of birthing facilities and quality reports may improve performance, but the recommended quality criteria need considerable financial and infrastructural expenditure.

Neugeborenen-Hörscreening in Deutschland – Ergebnisse der Evaluationen 2011/2012 und 2017/2018

ZusammenfassungHintergrundDas Neugeborenen-Hörscreening (NHS) wurde 2009 durch den Gemeinsamen Bundesausschuss (G-BA) mit Aufnahme in die Kinder-Richtlinie bundesweit eingeführt. Dabei wurden in der Kinder-Richtlinie auch Qualitätsziele festgelegt. Um die Qualität des NHS in Deutschland zu überprüfen, hat der G‑BA eine Bietergemeinschaft mit einer ersten Evaluation für die Jahre 2011/2012 und einer Folge-Evaluation für 2017/2018 beauftragt.MethodenGrundlage der Evaluationen waren Sammelstatistiken, die von allen geburtshilflichen und neonatologischen Abteilungen, als Leistungserbringer des NHS, geführt werden müssen und ggf. in Kooperation mit Hörscreening-Zentralen (HSZ) erstellt werden. Zusätzliche Daten wurden durch Fragebögen und Interviews erhoben und durch Routinedaten ergänzt, um den vollständigen Screeningprozess zu evaluieren.ErgebnisseIn 13 Bundesländern sind insgesamt 15 HSZ in den Screeningprozess eingebunden. Deutschlandweit wurde 2018 eine Screeningrate von 86,1 % (2012: 82,4 %) dokumentiert, die sich deutlich zwischen den Bundesländern unterschied. Die vorgegebenen Qualitätsziele konnten noch nicht überall umgesetzt werden. So erreichten nur knapp die Hälfte der Geburtsabteilungen die angestrebte Screeningrate von über 95 %. Beim Vergleich der Folge-Evaluation mit den Daten der ersten Evaluation konnte gezeigt werden, dass sich die Strukturqualität des NHS verbessert hatte, während die Prozessqualität eher gleich blieb oder schlechter geworden war, verdeutlicht insbesondere durch einen Anstieg der Refer-Rate (Kinder, die mit einem auffälligen Befund entlassen wurden) von 5,3 % auf 6,0 %.DiskussionZur Verbesserung der Qualität des NHS sollten flächendeckend HSZ etabliert und – wie in der Richtlinie vorgesehen – bei auffälligem Erstscreening ein zweites Screening noch vor Entlassung konsequenter durchgeführt werden.

Assessing biomechanical corrections: A comparison between Corvis ST and ICare tonometer for intraocular pressure measurement

This study aims to compare the accuracy of IOP measurements in pediatric patients using two different tonometers: ICare PRO and Corvis ST (CST). However, the choice of tonometers may vary between screening centers, depending on patient suitability. To address this, we enrolled 30 patients with retinopathy of prematurity over a period of 33 days for experimentation. A head-to-head comparison revealed a strong correlation between the Corvis ST (CST) and ICare PRO tonometers (r = 0.867). Furthermore, no significant difference was observed in IOP values obtained with the Corvis ST (CST) and ICare PRO tonometers (P > 0.05). However, it is worth noting that the Corvis ST (CST) measurements were significantly higher than those obtained from the ICare PRO tonometers (P < 0.05). In conclusion, this study demonstrates that the Corvis ST (CST) tonometer exhibits a high correlation coefficient comparable to that of the ICare PRO tonometer, making it a reliable tool for assessing IOP in pediatric patients. These findings are crucial for enhancing our understanding of the physiological function of melatonin in the eye and its potential to target melatonin receptors and their complexes for addressing various eye pathologies.

High HIV prevalence in gestational trophoblastic neoplasia patients.

To assess the HIV prevalence in patients diagnosed with gestational trophoblastic neoplasia (GTN). A retrospective single centre cohort study. A database from the Sheffield Trophoblastic Disease Centre (STDC), Sheffield, UK was searched between 1st January 2015 and 31st December 2021. A total of 3,591 patients were referred to STDC with a diagnosis of gestational trophoblastic disease (GTD), of which 221 (6.2%) were treated for GTN. The prevalence of HIV-positive tests in GTN patients was assessed. HIV testing was performed in 93% GTN patients ( n = 205/221). Overall, 1.3% of GTN patients ( n = 3/221) were HIV-positive, involving two known HIV-positive patients and one new diagnosis. This equates to a HIV prevalence of 14 : 1000, which is ∼7 to 9× higher than the HIV prevalence in Sheffield (1.9 per 1000) and Yorkshire and Humber (1.5 per 1000). Given the extremely high HIV prevalence in our population, 'opt out' HIV testing is recommended within our specialist trophoblastic centre for all referred GTD and GTN patients. There is little reason to suspect that the prevalence of HIV-positive patients is any lower in the cohort of GTD patients referred to specialist trophoblastic centres for hCG screening alone, without requiring chemotherapy, particularly considering that most GTN arises from GTD.

Prevalence and risk factors for high-risk human papillomavirus infection among women from three southern geopolitical zones of Nigeria.

Human Papillomavirus (HPV) infection is a risk factor for cervical cancer, the fourth most common cancer among women globally. Its burden is the highest in sub-Saharan Africa, with over 90% mortality. Interventions may fail without evidence-based data on stratified prevalence and risk factors among most at-risk women across Nigeria. A cross-sectional comparative study, with participants recruited from the Nigerian Institute of Medical Research's Clinics, NGO outreaches, a cancer screening centre and a university teaching hospital. Questionnaires were self-administered. Trained medics performed sampling at healthcare facilities, and self-sampling was used at outreaches. Nine hundred eighty-five study participants were recruited. About 37% and 27% of the women knew about HPV and its vaccines, respectively, but only 6% confirmed vaccination with HPV vaccines. HPV prevalence was highest among women with unknown marital status (35.9%), single women (33.8%), widowed/divorced/separated women (30.3%), and married/cohabiting women (19.6%). HPV infection was significantly higher among women who take alcohol (odds=1.7 [95% CI: 1.2-2.4]) and women who smoke (odds=2.6 [95% CI: 1.4 - 4.6]. HPV strains detected included HPV16 (1.3%), HPV18 (1.5%), Low Risk (0.2%) and Other High-Risk groups (19.7%). The inverse relationship between prevalence and education suggests interventions improving awareness and prevention would be impactful. Such interventions could also target HIV-positive women, women presenting with sexually-transmitted infections, who smoke and frequently drink alcohol.

EP14.32: General trends of twin pregnancies at the State Center for Timely Prenatal Screening of León, Guanajuato, Mexico

EP14.32: General trends of twin pregnancies at the State Center for Timely Prenatal Screening of León, Guanajuato, Mexico

EP09.13: Fetal transfusion outcomes at the State Center for Timely Prenatal Screening of León, Guanajuato, Mexico

EP09.13: Fetal transfusion outcomes at the State Center for Timely Prenatal Screening of León, Guanajuato, Mexico

EP08.24: Ultrasonographic findings of FIRS of the State Center for Timely Prenatal Screening

EP08.24: Ultrasonographic findings of FIRS of the State Center for Timely Prenatal Screening

Diagnostic performance of the fibrosis-4 index and the NAFLD fibrosis score for screening at-risk individuals in a health check-up setting.

The fibrosis-4 index (FIB-4) and the NAFLD fibrosis score (NFS) have been used as noninvasive screening methods for advanced fibrosis in patients with NAFLD. However, their diagnostic performance has not been evaluated in at-risk individuals regardless of hepatic steatosis. This study evaluated the performance of the FIB-4 and NFS in at-risk groups of health check-up examinees at mass screening centers. This retrospective, cross-sectional study included 8545 participants who underwent voluntary magnetic resonance elastography at a discounted fee during their regular health check-ups at 13 mass screening centers nationwide. The at-risk group was defined as those with any of the following conditions: NAFLD, 2 or more metabolic abnormalities, diabetes mellitus, or abnormal aminotransferase levels. A magnetic resonance elastography cutoff of ≥3.6kPa was used to define conventional advanced fibrosis. According to the proposed criteria, the proportion of at-risk individuals was 67.4%-80.2% in the health check-up cohort without viral or alcohol-associated liver disease. The prevalence of individuals with advanced hepatic fibrosis in each at-risk group was ~2.3%-2.8% according to various criteria. It was higher in patients without NAFLD than in those with NAFLD. A total of 28.2%-39.6% of those in each at-risk group did not show hepatic steatosis on ultrasonography. The performance of FIB-4 for advanced fibrosis in the at-risk group was comparable with that in the NAFLD group. FIB-4 showed a better area under the receiver operating characteristic curve and sensitivity than NFS in the at-risk group. FIB-4 demonstrated superior performance compared with the NFS, and its performance in at-risk individuals was similar to that observed for patients with NAFLD.

Implementation of Universal Newborn Hearing Screening in the Philippines: A Survey of Registered Newborn Hearing Centers.

Universal newborn hearing screening is mandated in the Philippines through the Universal Newborn Hearing Screening and Intervention Act of 2009 (RA 9709). Newborn hearing screening (NBHS) centers are required to perform screening tests, compile and submit data on screened newborns, and advise parents on the subsequent steps after NBHS. The study aimed to conduct a survey of the implementation of the Universal Newborn Hearing Screening and Intervention Program (UNHSIP) in the different regions of the country; and assess the information technology (IT) capabilities of hearing centers. Fifty-one NBHS centers across twelve regions were surveyed through on-site inspections in 2016. Data was gathered on the centers' testing capability, staffing, access to specialists, use of local protocols, connectivity, and IT capabilities. All surveyed centers followed the recommended protocols of the Manual of Operations of the Universal Newborn Hearing Screening and Intervention Act of 2009 (RA 9709). Among the 12 regions visited, only five (41.67%) had Category C centers with confirmatory testing and early amplification services as recommended. Majority of facilities (96.1%) were staffed by trained and certified personnel. A small percentage had access to subspecialists such as clinical audiologists (39.2%) and speech-language pathologists (23.5%). All facilities had computer access, but only 58.8% had internet access. Majority (94.1%) of the centers visited were not using the recommended data submission methods, specifically the use of registry cards and the online registry. Only 27.5% of centers had data on newborns who underwent confirmatory testing or early intervention. Facilities were found to be compliant to NBHS screening protocols and majority complied with certification requirements for staff; but were found to be non-compliant with use of registry cards or the online registry. Majority of centers were able to contact the parents of neonates who did not pass newborn screening, but had no system to track outcomes. Lack of confirmatory and early intervention services in identified areas emphasize the need for development of regional centers. It is recommended that measures to improve the utilization of the online registry are taken.