Senanayake M P, Jayasinghe J A
Department of Paediatrics, Faculty of Medicine, University of Colombo, Sri Lanka.
Ceylon Med J. 2014 Mar;59(1):13-5. doi: 10.4038/cmj.v59i1.6733.
To assess adherence to preventive care and age-appropriate screening in different age categories of Down syndrome (DS) persons.
This community-based retrospective observational study on ambulatory persons with DS from different regions of Sri Lanka was carried out on 100 randomly selected individuals from a sample framework of approximately 300. Their screening behavior for cardiac, ophthalmic, hearing and thyroid status was evaluated. Age at first medical consultation for DS specific complications, whether undertaken when symptomatic or asymptomatic, and use of DS-specific growth charts were extracted from medical records. Screening was compared in three age groups (<10, 10-15, and >15 years).
One hundred clinically diagnosed DS individuals (F: M 1:1.2) aged 2-28 years (mean 13.5 years) were from varied socio-economic backgrounds and rural (68%) suburban (20%) and urban (12%) settings. They all had had postnatal medical assessments. Initial eye, ENT, cardiac consultations was at significantly earlier ages in those below 10 years. Age-appropriate cardiac assessments occurred in 58%, 25% and 7.5% in each age group. Vision, hearing and newborn thyroid status were not routinely screened for. Only 7% had special growth charts. Area of residence had no effect on screening behavior.
Screening for complications in DS was delayed and inconsistent but occurred at significantly earlier ages in younger children. Use of appropriate growth charts was very low. Screening behavior was unaffected by area of residence. We recommend incorporating DS-specific medical checklists as a preventive health routine for this unique group of children.
评估不同年龄组唐氏综合征（DS）患者对预防性护理和适龄筛查的依从性。
这项基于社区的回顾性观察研究针对来自斯里兰卡不同地区的门诊DS患者，从约300人的样本框架中随机选取100名个体。评估了他们在心脏、眼科、听力和甲状腺状况方面的筛查行为。从病历中提取首次因DS特定并发症进行医学咨询的年龄，无论咨询是在出现症状时还是无症状时进行的，以及DS专用生长图表的使用情况。对三个年龄组（<10岁、10 - 15岁和>15岁）的筛查情况进行了比较。
100名临床诊断为DS的个体（女性：男性为1:1.2），年龄在2 - 28岁（平均13.5岁），来自不同的社会经济背景，居住在农村（68%）、郊区（20%）和城市（12%）地区。他们都接受了产后医学评估。10岁以下人群初次眼科、耳鼻喉科、心脏科咨询的年龄明显更早。各年龄组中适龄心脏评估的比例分别为58%、25%和7.5%。视力、听力和新生儿甲状腺状况未进行常规筛查。只有7%的人有特殊生长图表。居住地区对筛查行为没有影响。
DS并发症的筛查延迟且不一致，但年幼儿童的筛查年龄明显更早。合适生长图表的使用率非常低。筛查行为不受居住地区的影响。我们建议将DS专用医学检查表纳入这一特殊儿童群体的预防性健康常规检查中。
