AB014. Expanding newborn screening and the initiation of regional follow-up in the Philippines

Background: Newborn bloodspot screening (NBS) is a well-recognized public health prevention program aimed at identifying newborns that are affected by certain genetic/metabolic/infectious conditions. Early identification of these conditions is particularly crucial since timely intervention can lead to significant reduction in morbidity, mortality, and associated disabilities in affected newborns. Newborn screening systems have existed in many developed countries for over 40 years, but they are still in development in low-income settings. While developing programs are focusing on 1 or 2 prominent congenital conditions, developed programs now screen for more than 50 different conditions. Newborn screening in the Philippines began as a small pilot program in Manila in 1996 and became a nationwide program institutionalized in a 2004 law that requires that NBS to be offered to all newborns, supported by national health insurance. While the screening mandate includes 6 conditions, recent expansion has allowed for inclusion of over 20 conditions at an additional charge. To facilitate clinical follow-up, a network of regional follow-up centers has been implemented using a team approach. A recently implemented genetic counseling program is providing much needed trained personnel to assist with counseling activities across the country

Objective: This presentation will briefly review the implementation of newborn screening in the Philippines and address the considerations involved in expanding to over 20 screened conditions in a resource poor setting. Additionally, it will review the implementation of genetic counseling training and development of a regional clinical follow-up team approach in order to speed and improve needed access to clinical care.

Methods: Expansion of newborn screening to include metabolic conditions detectable with tandem mass spectrometry has included extensive training with support from developed programs in the U.S. and Australia. Likewise, expanded screening for thalassemias and other hemoglobinopathies and miscellaneous other conditions has included similar activities. To augment the clinical and other medical services needed as part of follow-up, a genetic counseling training program has been initiated the regional follow-up teams.

Results and conclusions: NBS in the Philippines now includes screening for over 20 conditions including multiple metabolic and hemoglobin conditions detectable though multiplex laboratory procedures. Centralized, regional follow-up teams including a physician, nurse, counselor and administrative staff have been initiated in all public health regions in the country. National insurance is considering the addition of expanded screening conditions into its ongoing payments for basic newborn screening.

Keywords: Expanded newborn screening; regional follow-up; Philippine newborn screening; genetic counselling