newborn screening
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Newborn Screening
Ideally, your baby undergoes Newborn Screening (NBS) within three days of his birth. NBS will be able to tell if your
baby was born with any metabolic disorders that will affect his body's normal processes and functions.
What is my baby being screened for?
Currently, NBS tests for five disorders:
• Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency
A condition where the body lacks the enzyme called G6PD. The deficiency may cause hemolytic anemia, when the
body is exposed to oxidative substances found in certain drugs, foods and chemicals. Parents of G6PD-positive
babies receive a list of these substances from their doctor.
While this is the mildest disorder that is covered in NBS, it is the most common: One out of 55 babies may be
affected. Read more in our article on G6PD deficiency.
• Congenital Hypothyroidism
This is a lack of thyroid hormone, which your baby needs to grow. Treatment is required within the first four weeks of
a baby's life to prevent stunted physical growth and mental retardation. One out of 3,369 babies is at risk.
• Congenital Adrenal Hyperplasia
An endocrine disorder that causes severe salt loss, dehydration and abnormally high levels of male sex hormones.
Left undetected and untreated, it can be fatal within seven to 14 days. One in 7,960 babies is at risk.
• Galactosemia
A condition in which babies cannot process the sugar present in milk (galactose). This leads to increased galactose
levels in the body, which leads to liver and brain damage. It also causes cataracts to develop. One in 82,250 babies
may be affected.
• Phenylketonuria
A condition where the body does not properly use the enzyme phenylalanine, which may lead to brain damage. One
in 109,666 babies may be at risk.
Is it really necessary to screen my baby?
It is crucial that these disorders are detected as early as possible. An affected baby looks healthy at birth because
symptoms do not begin to show until weeks or months later. Once the signs and symptoms set in, the ill effects are
often already permanent. If these conditions are left untreated, they may cause health complications or inhibit mental
development. In the most serious cases, they can cause death.
The Philippine Newborn Screening Project says that 33,000 children out of the two million Filipino babies born yearly
are at risk from these disorders.
Fortunately, children diagnosed with any of these disorders can continue to live normal and healthy lives as long as
they are treated in time and they consistently follow up with a specialist.
How is Newborn Screening administered?
Your baby will be pricked at the heel. Three drops of blood will be taken for testing.
A negative screen means that results are normal. A positive screen will require the baby to undergo further testing by
a pediatrician. Parents are oriented about their child’s condition through the National Institutes of Health (at the
Philippine General Hospital). Parents will be notified through mail and through their attending doctors about positive
results, and will be required to undergo the orientation and further testing at the NIH.
Is NBS compulsory?
The Department of Health and other health organizations strongly recommend that all babies undergo Newborn
Screening. Most tertiary centers are accredited Newborn Screening testing centers. If a baby is delivered at home or
in a primary health care setting or lying in, the baby can be brought to the nursery of any accredited center after the
48th hour of life for testing (on out - patient basis).
Sometimes, parents decline for various reasons, such as religious concerns. In these cases, they are asked to
acknowledge in writing that they understand the benefits of NBS and that they know they may be placing their
newborn at risk for undiagnosed congenital conditions by declining the test. This dissent form is included in the
baby's medical record and is recorded in the National Newborn Screening Database.
Newborn Screening
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Republic Act 9288
Newborn screening (NBS) is a public health program aimed at the early identification of infants who are
affected by certain genetic/metabolic/infectious conditions. Early identification and timely intervention can
lead to significant reduction of morbidity, mortality, and associated disabilities in affected infants. NBS in the
Philippines started in June 1996 and was integrated into the public health delivery system with the
enactment of the Newborn Screening Act of 2004 (Republic Act 9288). From 1996 to December 2010, the
program has saved 45 283 patients. Five conditions are currently screened: Congenital Hypothyroidism,
Congenital Adrenal Hyperplasia, Phenylketonuria, Galactosemia, and Glucose-6-Phosphate Dehydrogenase
Deficiency.
Current Status of NBS Implementation in the Philippines
Newborn Screening Legislation
NBS was integrated into the public health delivery system with the enactment of Republic Act 9288 or
Newborn Screening Act of 2004 as it institutionalized the ‘National NBS System’, which shall ensure the
following: [a] that every baby born in the Philippines is offered NBS; [b] the establishment and integration of
a sustainable NBS System within the public health delivery system; [c] that all health practitioners are aware
of the benefits of NBS and of their responsibilities in offering it; and [d] that all parents are aware of NBS
and their responsibility in protecting their child from any of the disorders. The highlights of the law and its
implementing rules and regulations are:
1. DOH is the lead agency tasked with implementing this law;2. Any health practitioner who delivers or assists in the delivery of a newborn in the Philippines shall prior
to delivery, inform parents or legal guardians of the newborns the availability, nature and benefits of NBS;
3. Health facilities shall integrate NBS in its delivery of health services;4. Creation of the Newborn Screening Reference Center at the National Institutes of Health and
establishment and accreditation of NSCs equipped with a NBS laboratory and recall/follow up program;5. Provision of NBS services as a requirement for licensing and accreditation, the DOH and the Philippine
Health Insurance Corporation (PHIC)6. Inclusion of cost of NBS in insurance benefits
Currently, there are four Newborn Screening Centers (NSCs) in the country: NSC-National Institutes of Health
in Manila; NSC- Visayas in Iloilo City; NSC-Mindanao in Davao City; and NSC-Central Luzon in Angeles City.
The four NSCs provide laboratory and follow up services for more than 3000+ health facilities.
DOH, its partners and major stakeholders remain aggressive in identifying strategies to intensify awareness
in the communities and increase coverage among home deliveries. Among the recent efforts to increase the
newborn screening coverage are appointment of full-time Regional NBS Coordinators; opening more G6PD
Confirmatory Laboratories; partnership with midwives organizations; and production of information materials
targeting different groups of health workers and professionals.
Key Players in the Implementation
Organizational chart for the national implementation of Newborn Screening
Newborn Screening Statistics
As of December 2010, there are 2,389,959 babies that have undergone NBS and based on these data, the
incidences of the following disorders are: CH (1: 3,324); CAH (1: 9,446); PKU (1: 149,372); Gal (1: 108,635)
and G6PD deficiency (1: 52). The program has saved the following numbers of newborns from complications
and/or death: 719 from CH, 253 from CAH, 22 from Gal, 16 from PKU and 44 273 from G6PD deficiency.
Coverage
As of December 2010, the coverage of NBS is at 35%.
DIRECTORY OF PROGRAM IMPLEMENTERS
National Center for Disease Prevention and Control –Family Health Office
Program Manager
Dr. Juanita A. Basilio
Dr. Anthony P. Calibo
National Newborn Screening Coordinator:
Ms. Lita Orbillo
San Lazaro Compound, Sta. Cruz, Manila
Telephone: (02) 7359956
Newborn Screening Reference Center
Director: Dr. Carmencita D. Padilla
National Institutes of Health
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: [email protected]
www.newbornscreening.ph
Newborn Screening Centers
For Regions I, II, III & CAR
Unit Head: Dr. Florencio Dizon
Newborn Screening Center – Central Luzon
Angeles City University Foundation Medical Center
MacArthur Highway, Barangay Salapungan, Angeles City
Telephone: (045) 6246502-03; Email: [email protected]
For Regions IV, V & NCR
Newborn Screening Center– National Institutes of Health
Unit Head: Ms. Ma. Elouisa Reyes
Building H, UP Ayala Land Technohub
Complex,Commonwealth Avenue, Brgy. UP Campus
Diliman, Quezon City
Email: [email protected]
For Visayas
Newborn Screening Center– Visayas
Unit Head: Dr. J Winston Edgar Posecion
West Visayas State University Medical Center
E. Lopez St., Jaro, Iloilo City
Telefax: (033) 329-3744; Email: [email protected]
For Mindanao
Newborn Screening Center– Mindanao
Unit Head: Dr. Conchita Abarquez
Southern Philippines Medical Center
J.P. Laurel Avenue, Davao City
Telephone: (082) 226-4595 / 224-0337
Telefax (082) 227-4152; Email:[email protected]
Centers for Health Development
CHD Mailing Address Business PhoneNBS Regional Coordinator
CHD 1 - Ilocos San Fernando, La Union(072) 2425315; (072) 2424773
Clarita B. Lewis, RN
CHD 2 - Cagayan Valley
Tuguegarao City(078) 3046585; (078) 8446585; (078) 8446523
Leticia T. Cabrera, MD, MPA
CHD 3 - Central Luzon
San Fernando, Pampanga(045) 4552324; (045) 9617649; (045) 9617654
Adelina Cabrera, RN
CHD 4-A Calabarzon
QMMC Compound, Project 4, Quezon City
(02) 4403372Maria Luisa M. Malana, RN
CHD 4-B Mimaropa
Quirino Hospital Compound, Quezon City
(02) 9134650; (02) 9115025
Ma. Teresa Castillo, MD
CHD 5- BicolFirst Park Subdidivion, Daraga, Albay
(052) 4830840loc 517/516
Carla A. Orozco, MD, MPHMS III
CHD 6 - Western Visayas
Q. Abeto St., Mandurriao, Iloilo City
(033)3210364Renilyn P. Reyes, MD
CHD 7 - Central Visayas
Osmeña Blvd., Cebu City (032) 4187633Nayda P. Bautista,MD, MPH
CHD 8- Eastern Visayas
Candahug, Palo , Leyte (053)3235025Lilibeth Andrade, MD
CHD 9 - Zamboanga Peninsula
Upper Calarian, Zamboanga City
(062)9830314-15Nerissa B. Gutierrez, RN
CHD 10 - Northern Mindanao
J.V. Seriña St., Carmen, Cagayan de Oro City
088-22- 727400Ellenietta HMV N. Gamolo, MD, MPH
CHD 11 - Davao Region
J.P. Laurel Avenue, Davao City
(082) 3051907; (082) 2214011
Ma. Clarose M. Mascardo, RN, MPH
CHD 12 - Central Mindanao
ARMM Compound, Gov. Guttierez Ave, Cotabato City
(064) 4217436; (064) 4218053
Lucy Decio, RN
CHD CARAGAPizarro St. cor. Narra Rd. Butuan City
(085) 3411452Glynna B. Andoy, MD, MPH
CHD CARBGHMC Compound, Baguio City
(074) 4428096; (074) 4445255
Nicolas R. Gordo, Jr, MD
CHD NCRWelfareville Compound, Brgy. Addition Hills, Mandaluyong City
(02) 7183097; (02) 5354521
Ma. Paz P. Corrales, MD
CHD ARMMORG Compound, Cotabato City
(064) 4217703Dayan Sangcopan, MD
Reunion of Saved Babies, October 10, 2010 at the UP Bahay ng Alumni, Quezon City
Newborn Screening Poster
Continuing Education for Health Professionals, October 4, 2011 in La Union
The Heel Prick Method
NBS Awarding Ceremony
October 3, 2011
Traders Hotel