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[马德里自治区新生儿筛查中检测出的镰状细胞病新生儿的初级保健随访]

[Primary care follow-up of newborns with sickle cell disease detected in neonatal screening in the Community of Madrid].

作者信息

Rodríguez-Moldes B, Carbajo A J, Sánchez B, Fernández M, Garí M, Fernández M C, Álvarez J, García A, Cela E

机构信息

Atención Primaria Guadalajara, Castilla-La Mancha, España.

Atención Primaria, Comunidad de Madrid, Madrid, España.

出版信息

An Pediatr (Barc). 2015 Apr;82(4):222-7. doi: 10.1016/j.anpedi.2014.04.007. Epub 2014 May 17.

Abstract

OBJECTIVES

The main aim of the study was to assess the effects of the recommended preventive program in the population affected with Sickle Cell Disease in Primary Care. The program included, antibiotic prophylaxis, immunizations and health education, following the introduction of universal neonatal screening program for Sickle Cell Disease in the Community of Madrid.

PATIENTS AND METHODS

A cross-sectional observational study was performed with retrospective data collected from a cohort of newborns with Sickle Cell Disease diagnosed by neonatal screening test in the Community of Madrid.

RESULTS

From the data obtained from a sample of 20 patients, it was found that 95% had been diagnosed by the newborn screening test performed between 5 and 13 days of life. The mean age was 39 months when the study was conducted. During follow-up, from Primary Care Paediatric clinic, it was observed that the compliance for antibiotic prophylaxis was 90%, and the coverage for the official vaccination schedule was 85%. Specific vaccine coverage as a risk population was highly variable (85% for pneumococcal 23V, 50% for influenza, and 15% for hepatitis A). Health education only reached one in every four families.

CONCLUSIONS

Acceptable compliance with antibiotic prophylaxis was observed during the follow-up of patients with sickle cell disease in Primary Care, but a low coverage of routine immunization, as well as specific immunizations. Coverage of health education was very low. Improving these parameters would require greater coordination and involvement of Primary Care Professionals so that these patients were followed up appropriately, and could be translated into a reduction of disease complications and an improvement in the quality of life of these patients.

摘要

目的

本研究的主要目的是评估在初级保健中针对受镰状细胞病影响人群实施的推荐预防方案的效果。在马德里社区引入镰状细胞病新生儿普遍筛查方案后,该方案包括抗生素预防、免疫接种和健康教育。

患者与方法

采用横断面观察性研究,收集马德里社区通过新生儿筛查试验诊断为镰状细胞病的一组新生儿的回顾性数据。

结果

从20例患者样本获得的数据发现,95%是在出生后5至13天进行的新生儿筛查试验中被诊断出来的。开展研究时的平均年龄为39个月。在随访期间,从初级保健儿科诊所观察到,抗生素预防的依从率为90%,官方疫苗接种计划的覆盖率为85%。作为风险人群的特定疫苗覆盖率差异很大(23价肺炎球菌疫苗为85%,流感疫苗为50%,甲型肝炎疫苗为15%)。健康教育仅覆盖了四分之一的家庭。

结论

在初级保健中对镰状细胞病患者进行随访期间,观察到抗生素预防的依从性尚可,但常规免疫接种以及特定免疫接种的覆盖率较低。健康教育的覆盖率非常低。改善这些参数需要初级保健专业人员进行更大程度的协调和参与,以便对这些患者进行适当的随访,并可转化为疾病并发症的减少和这些患者生活质量的提高。

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