Sack J, Feldman I, Kaiserman I
Department of Pediatrics, Sheba Medical Center, Tel Hashomer, Israel.
Horm Res. 1998 Sep;50(3):151-4. doi: 10.1159/000023264.
Screening for congenital hypothyroidism (CH) among the Arab population of the West Bank began in May 1987 as part of the neonatal screening program in Israel. In the West Bank many infants are born at home or are released from the hospital on the 1st day after birth and thus cannot be screened. However, we tried to reach the infants before the age of 1 month at the maternal and child health centers, where they receive immunization. In this screening program, 64% of the infants were sampled by the 1st week and 93% by 3 weeks of life. In contrast to the screening in Israel, where thyroxine determination is followed by thyroid-stimulating hormone measurement, in the West Bank thyroid-stimulating hormone was tested first in order to decrease the recall rates. From June 1990 to February 1994, 49,694 infants were screened in the West Bank, of whom 24 with CH were detected (an incidence of 1:2,070). From January 1987 to February 1994, 28,938 infants were screened in East Jerusalem, of whom 20 with CH were detected (incidence 1:1,447). There were differences between the incidence rates in the various districts. The incidence rates were higher than those reported from industrialized countries, but similar to those found in Saudi Arabia. This may be due to the high degree of consanguineous marriages among Arab populations and to environmental factors. In conclusion, in spite of the many difficulties, both practical and political, CH screening in the West Bank is feasible. Although screening all newborns shortly after birth is not possible, this study shows that a high percentage of them can be screened at a time when they can still be effectively treated. Our results could be used in due time as a baseline for a future independent screening program.
1987年5月，作为以色列新生儿筛查项目的一部分，约旦河西岸阿拉伯人群中的先天性甲状腺功能减退症（CH）筛查工作启动。在约旦河西岸，许多婴儿在家中出生，或者在出生后第1天就出院了，因此无法接受筛查。不过，我们试图在母婴健康中心对1月龄前的婴儿进行筛查，这些婴儿在该中心接受免疫接种。在这个筛查项目中，64%的婴儿在出生后第1周接受了采样，93%的婴儿在出生后3周内接受了采样。与以色列的筛查不同，以色列是先测定甲状腺素，然后测量促甲状腺激素，而在约旦河西岸，为了降低召回率，首先检测促甲状腺激素。1990年6月至1994年2月，约旦河西岸对49,694名婴儿进行了筛查，其中24名被检测出患有CH（发病率为1:2,070）。1987年1月至1994年2月，东耶路撒冷对28,938名婴儿进行了筛查，其中20名被检测出患有CH（发病率为1:1,447）。不同地区的发病率存在差异。这些发病率高于工业化国家报告的发病率，但与沙特阿拉伯的发病率相似。这可能是由于阿拉伯人群中近亲结婚的比例较高以及环境因素所致。总之，尽管存在诸多实际和政治上的困难，但约旦河西岸的CH筛查是可行的。虽然不可能在出生后不久就对所有新生儿进行筛查，但这项研究表明，在他们仍能得到有效治疗时，可以对很大比例的新生儿进行筛查。我们的结果可适时用作未来独立筛查项目的基线。
