Minas Gerais Agency | Extended leg tests have already identified 105 children this year
Since January of this year, the Minas Gerais State Health Department (SES-MG) has expanded the Neonatal Screening Program (PTN), known as the Foot Test. With the expansion, the diseases diagnosed in the test went from six to 12. In Minas Gerais, 74,000 children underwent this initial screening in 2022. There were 92 suspected cases of congenital toxoplasmosis and 13 cases of fatty acid beta-oxidation (DOAG) related diseases. Cases are under analysis and patients were referred for complementary examination and consultation with specialists.
Today is Monday (7/8) National Foot Test Day. The test is performed between the 3rd and 5th day of a newborn’s life and aims to detect metabolic, genetic, and infectious diseases early. PTN-MG has been implemented in 853 municipalities of Minas Gerais and provides SUS testing for the entire population. There are 3,744 collection points, including 3,658 Basic Health Units (UBS) and 86 registered maternity hospitals that examine hospitalized children.
For the expansion of PTN, SES-MG will pay an annual fee of R $ 13,157,148.77, specifying the cost of screening tests, complementary diagnoses and treatment. SES-MG Resolution No. 7,916 of December 9, 2021, which governs the action, proposes not only screening of the Hill Prick test, but also treatment, follow-up and all necessary assistance and support for it. Continuity of care. In the health care network.
According to Wagner Fulgencio Elias, Technical Reference for Maternal and Child Coordination at SES-MG, it is important for parents or guardians of the newborn to be aware of the importance of the heel prick test and to take the child to the primary health unit. The material is collected as soon as possible. “It’s a quick, free trial, available in all municipalities in the state and it does not cause discomfort to children. Tests are likely to identify some health conditions that, if treated quickly, can reduce symptoms and sequelae, which guarantees more adequate health continuity for children, ”he reports.
For tabulation and analysis of results, SES-MG has established a partnership with UFMG’s Faculty of Medicine’s Center for Action and Research in Diagnostic Support (NUPAD). Screening tests are collected at Basic Health Units across the state and sent to Nupada. According to data already analyzed, about 74,000 newborns were screened between January and May this year. The detected cases of toxoplasmosis came from 78 municipalities in Minas Gerais, while DOAG in 12 cities.
Anna Lucia Sterling, academic coordinator of Nupada and a retired professor in UFMG’s Faculty of Medicine, positively evaluates the expansion of PTN in the state. “The SUS Health Network in municipalities is already accustomed to PTN collection and flowcharts and the expansion was well received. From the point of view of execution, collection and delivery of material, nothing has changed for primary care professionals or for patients. Diseases are screened on the filter paper by collecting the same blood from the newborn’s ankles, dried and sent to the ankle, ”he explained.
On May 26, 2021, Federal Law No. 14,154 was enacted to improve the National Neonatal Screening Program (PNTN), establishing a minimum list of diseases screened through biological neonatal screening tests. The law emphasizes that the proposed expansion will be implemented in a smooth and progressive manner. As established in SES / MG Resolution No. 7,916 of December 9, 2021, SES-MG has been working to expand PTN slowly and steadily, with a total of five stages. Currently, the expansion includes the first phase.
By the end of 2021, Minas Gerais was screening newborns for congenital hypothyroidism, phenylketonuria, sickle cell disease, cystic fibrosis, biotinidase deficiency, and congenital adrenal hyperplasia. With Resolution No. 7,916, the diseases included include congenital toxoplasmosis, fatty acid beta-oxidation disorder, moderate-chain acyl-coa deficiency, very long-chain acyl-coa deficiency, long-chain 3-OH-acylCoA. And primary carnitine deficiency.
Between 2018 and 2022, 953,490 children were screened in the state of Minas Gerais. See the annual breakdown below:
As soon as a child’s test results change, the municipality of the patient’s residence is triggered. Thus, counseling and special tests are prescribed to confirm the diagnosis or not. If confirmed, the patient is immediately referred for treatment by SUS.
For Anna Lucia Sterling, the biggest challenge is the clinical follow-up of screened patients, as it may be necessary for life. “We have increased the number of patients referred to referral services, mainly for toxoplasmosis. This affects the network of these services Some of these diseases can lead to acute conditions and therefore, primary health care must be prepared to welcome patients, respond to family demands and suspicions, ”he highlighted.
The table below shows the incidence of disease screened before PTN expansion in the state of Minas Gerais. For diseases that began testing in 2022, Nupad makes it clear that the sample is still small and, therefore, does not allow to safely estimate the actual incidence of these diseases in the Minas Gerais region.