Evaluatie van de uitvoering van de hielprik ten behoeve van de PKU/CHT-screening bij pasgeborenen
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Type
OnderzoeksrapportLanguage
nl
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Evaluatie van de uitvoering van de hielprik ten behoeve van de PKU/CHT-screening bij pasgeborenenTranslated Title
Assesment of performance in carrying out the heelstick used in neonatal screening for phenylketonurea (PKU) and congenital hypothyroidism (CHT)Publiekssamenvatting
In de kwartaalrapportages van de PKU/CHT screeningslaboratoria wordt onder andere nagegaan of de hielprik conform de in het Draaiboek PKU en CHT gestelde eisen wordt uitgevoerd. Daarbij wordt gekeken naar de termijn tussen geboorte- en hielprikdatum, tussen hielprikdatum en datum van analyse en tussen geboortedatum en datum van analyse. Tevens wordt geregistreerd in hoeverre de voor de uitvoering van de screening van belang zijnde demografische gegevens op de setjes zijn ingevuld. Het probleem is echter dat de hielpriksetjes, waarop deze rapportages zijn gebaseerd, geen aselecte steekproef vormen. Daarom werd besloten in een aselecte steekproef een aantal van bovengenoemde aspecten te analyseren. Van in totaal 5000 setjes (1000 per laboratorium) werd een aantal gegevens geregistreerd. De gegevens werden vervolgens geanalyseerd per categorie uitvoerder van de hielprik, per provinciale entadministratie en per laboratorium. Per provincie bestaan grote verschillen tussen de categorieen uitvoerders van de hielprik. Op gemiddeld 6.9% van de setjes was niet pasgeborenen met een geboortegewicht < 2500 gram ontbrak de zwangerschapsduur. Op dag 7, de laatst aanbevolen dag, was 94% van de pasgeborenen geprikt. Op dag 3 na de hielprik zijn nog slechts 81% van alle setjes in het laboratorium ontvangen/geanalyseerd. Met name de regio Noord-West Nederland valt hierbij in negatieve zin. De bezorging van de setjes door de PTT laat overigens duidelijk te wensen over.<br>In the Netherlands the neonatal screening for phenylketonurea (PKU) and congenital hypothyroidism (CHT) is performed by 5 laboratories. The heelstick is carried out between day 5 and 7, the day of birth being counted as day 0. For the screening programme to be efficient it is important that the heelstick is carried out in time and all necessary data are filled out on the sheet with the demographical data. Each trimester a report on the analytical quality of the screening programme is prepared by the RIVM in cooperation with the other screening laboratories. In these reports attention is paid to some logistical aspects of the screening also. However, the data used for these evaluations are not representative for the whole neonatal population, because they are based only on newborns which were selected in the screening for the request of a repeat heelstick or were referred to a paediatrician. Therefore a random check of 5000 heelstick samples was taken and evaluated for a number of logistical aspects. Results are presented per province, per laboratory and per category performers of the heelstick. The filling out of the sheets with the demographical data was poor: on average 8% of data missing. Only 44% of the heelstick was performed on the preferred day 5, but this percentage varied strongly with the category performer of the heelstick. On day 7, the last recommended day, 94% of the newborns were sampled. On day 3 after the sampling date, only 81% of the sets is received/analysed by the laboratories; the laboratory in the region North-West scored only 55%, but this is due to a poor service of the mail company PTT.<br>
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