Department of Hygiene and Public Health, Osaka Medical College.
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University.
Tohoku J Exp Med. 2020 Dec;252(4):365-372. doi: 10.1620/tjem.252.365.
Biliary atresia (BA) is the most frequent hepatic cause of death in early childhood. Early referral and timely Kasai portoenterostomy are essential for the improvement of long-term native liver survival rate of BA patients. Screening with stool color card (SCC) has been implemented in Japan since 1994. Recently current digital edition of SCC consisted of seven digitally created images was introduced to China. Our study aimed to evaluate the repeatability and reliability of same edition of SCC used in Beijing, China and Sapporo, Japan. In Beijing from 2013 to 2014, SCCs were distributed to infants' guardians by trained nurses in maternal facilities during information sessions on neonatal screening programs. SCC was used at three checkpoints for each infant after birth for screening. The SCC data were collected from 27,561 infants (92.5%) in Beijing by 42-day health checkup, mobile phone and social network services. In Sapporo from 2012 to 2015, the SCCs with a postcard and guardian instructions were inserted into Maternal and Child Health Handbook and distributed to all pregnant women. The data were collected from a total of 37,478 (94.3%) infants in Sapporo via the postcard during the 1 month infant health checkup. We thus identified two BA patients in Sapporo and two BA patients in Beijing. High rates of sensitivity and specificity in both cities were observed. The frequency distribution of color images on SCC reported in both cities was similar. This study shows excellent repeatability and reliability of the current digital edition of SCC.
先天性胆道闭锁（BA）是儿童早期最常见的肝脏死亡原因。早期转诊和及时的 Kasai 门腔分流术对于提高 BA 患者的长期原生肝存活率至关重要。自 1994 年以来，日本一直在使用粪便颜色卡（SCC）进行筛查。最近，中国引入了当前的数字版 SCC，由七个数字化创建的图像组成。我们的研究旨在评估中国北京和日本札幌使用的同一版 SCC 的可重复性和可靠性。在北京，从 2013 年到 2014 年，训练有素的护士在母婴保健信息会上向婴儿监护人分发 SCC。SCC 用于出生后每个婴儿的三个检查点进行筛查。通过 42 天健康检查、移动电话和社交网络服务，从北京的 27561 名婴儿（92.5%）中收集 SCC 数据。在札幌，从 2012 年到 2015 年，带有明信片和监护人说明的 SCC 被插入母婴保健手册中，并分发给所有孕妇。通过在 1 个月婴儿健康检查期间的明信片，总共从札幌的 37478 名婴儿（94.3%）中收集了数据。因此，我们在札幌发现了 2 名 BA 患者，在北京发现了 2 名 BA 患者。两个城市的 SCC 都表现出高灵敏度和特异性。两个城市报告的 SCC 彩色图像的频率分布相似。这项研究表明当前数字版 SCC 具有出色的可重复性和可靠性。
