CONGENITAL HYPOTHYROIDISM SCREENING IN A SERVICES HOSPITAL IN CENTRAL INDIA

Dr (Col) Om Prakash Singh; Lt Col Aneesha Begum; Dr. Neeraj Anand

Volume : VIII, Issue : VIII, August - 2018

CONGENITAL HYPOTHYROIDISM SCREENING IN A SERVICES HOSPITAL IN CENTRAL INDIA

Dr Col Om Prakash Singh, Lt Col Aneesha Begum, Dr. Neeraj Anand

Abstract :

Newborn screening is a cost–effective preventive health measure .Congenital hypothyroidism is one of the commonest preventable cause of mental retardation in India and worldwide. Early diagnosis of congenital hypothyroidism and targeted management strategies may prevent this epidemic.Various guidelines recommend measurement of Thyroid stimulating hormone(TSH),Thyroxin(T4) or both TSH and T4, for screening of this epidemic of Congenital hypothyroidism within 2––4 days of life, and in Preterms and low birth weight babies additionally after 2 weeks. There should be a follow up screening if lab test is positive along with non invasive scintigraphy and/or USG.L–Thyroxin is the first line treatment with standard dosages of 10–15 µg/kg/day based on severity ,with regular follow up to03 years of age thereafter. The government and the policymakers should ing out mandatory newborn screening programmes for early detection and treatment ofCongenital hypothyroidism.In India Congenital hypothyroidism is compounded by a lack of efficient newborn screening programmes, non availability of infrastructure and the rising cost of health care. Objective: To study the incidence of congenital hypothyroidism in a services hospital in central India. Design: Prospective observational study. Setting:Military hospital Jabalpur. Participants: All babies born in Military hospital Jabalpur during the study period Jul 2012 to Jun2015. Methods:Cord blood samples were collected immediately after birth and assayed by chemiluminiscenct immunoassay method. Age related cut–offs were applied for recall for TSH. Main outcome measure: Recall rate for hypothyroidism, diagnosis of congenital hypothyroidism Results: Screening for congenital hypothyroidism was carried out for1030 newborns. Hundred percent of those recalled for confirmatory sampling responded. Using fixed TSH cut off of 20µIU/L, yielded high recall rate of 20%.Three babies were found to have congenital hypothyroidism. The mothers of these babies were all undiagnosed cases of hypothyroidism. The incidence of Congenital Hypothyroidism in this study was 1:340. Conclusions:. There is very high incidence of congenital hypothyroidism as reported in this study 1:340.and is higher than most of the studies in India. Effective treatment is available and if started timely will prevent a lot of morbidity. There is urgent need to incorporate newborn screening for congenital hypothyroidism at all levels, government and public. Newborn screening can be successfully carried out in India.