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马来西亚新生儿严重联合免疫缺陷症筛查:现状、挑战和进展。

Newborn screening for severe combined immunodeficiency in Malaysia: current status, challenges and progress.

机构信息

Department of Pediatric, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Research Center, Hospital Tunku Ampuan Besar Tuanku Aishah Rohani, Universiti Kebangsaan Malaysia (UKM) Specialist Children's Hospital, Kuala Lumpur, Malaysia.

出版信息

Front Immunol. 2024 Oct 2;15:1456769. doi: 10.3389/fimmu.2024.1456769. eCollection 2024.

Abstract

INTRODUCTION

Early diagnosis of Severe Combined Immunodeficiency (SCID) increases survival outcomes and quality of life while significantly minimizing healthcare burden and costs. Despite growing evidence supporting the benefits and cost-effectiveness of SCID detection through newborn screening (NBS), it has yet to be implemented in Malaysia. This study aims to explore experts' opinions on the current status, challenges, and crucial strategies needed for the successful implementation of SCID NBS.

METHODOLOGY

A guided, structured interview was employed to explore opinions on the current status, barriers, and strategies for implementing SCID NBS in Malaysia. All 13 invited experts participated in this study, indicating complete participation from the entire Malaysian immunology fraternity (consisting of eight clinical immunologists and five immunopathologists).

KEY FINDINGS

Several initiatives are ongoing to establish SCID NBS in Malaysia. Hindrances such as low immunologist-to-patient ratio, unequal placements of immunologists throughout Malaysia, society's low disease awareness, national health prioritization, lack of stakeholder engagement, and inadequacy of local study/data were highlighted. Pilot research on SCID NBS, advocacy workshops, and promotion materials are among the ongoing activities outlined in the blueprint, paving the way for this nationwide NBS program to be achievable in the near future.

CONCLUSION

This article provides recommendations to policymakers in mandating SCID NBS. Strategies by key stakeholders are underway, particularly in advocacy programs and efforts to increase awareness among clinicians and the public.

摘要

引言

早期诊断重症联合免疫缺陷症(SCID)可以提高存活率和生活质量,同时显著减轻医疗负担和成本。尽管越来越多的证据支持通过新生儿筛查(NBS)来检测 SCID 的益处和成本效益,但马来西亚尚未实施这一筛查。本研究旨在探讨专家对当前 SCID NBS 的实施状况、挑战和关键策略的看法。

方法

采用指导式结构化访谈,探讨马来西亚 SCID NBS 的当前状况、障碍和实施策略。本研究邀请了 13 名专家参与,这表明整个马来西亚免疫学界(包括 8 名临床免疫学家和 5 名免疫病理学家)都完全参与了研究。

主要发现

马来西亚正在开展多项建立 SCID NBS 的计划。存在一些障碍,如免疫学家与患者的比例低、免疫学家在马来西亚的分布不均、社会对该病的认知度低、国家卫生重点、利益相关者的参与度低以及当地研究/数据不足等。SCID NBS 的试点研究、宣传研讨会和推广材料是蓝图中列出的正在进行的活动,为该全国性 NBS 计划在不久的将来得以实现铺平了道路。

结论

本文为决策者制定 SCID NBS 提供了建议。主要利益相关者正在制定策略,特别是在宣传计划和提高临床医生和公众意识方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a75f/11479922/e7385586b09f/fimmu-15-1456769-g001.jpg

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