Abstract
Background
The aim of this pilot study in Beijing, China, was to validate a screening system for early detection of biliary atresia (BA) by using a modified version of the stool color card (SCC).
Methods
From 2013 to 2014, a total of 29 799 live born infants were screened. SCC was distributed in maternal facilities. Guardians were asked to check their infants’ stool colors daily using SCC up until four months after birth. The screening results among 92.5% of participants were reported. Cases deemed as high risk were referred to a surgical department immediately.
Results
Based on the results reported by the guardians, 24 infants showed pale-pigmented stools, of which two males without obvious signs of jaundice were diagnosed with BA at 52 and 55 days of age, respectively. The sensitivity was 100% and specificity was 99.9%. Four infants were confirmed as having other diseases. Two female patients failed to be screened by the SCC because they had severe jaundice and were referred to the Neonatal Intensive Care Unit after birth. They were diagnosed as BA at 14 and 17 days after birth, respectively. The overall prevalence of BA in this study was 1.3 in 10 000 live births.
Conclusion
The modified SCC was effective and feasible for early detection of BA, especially for patients with no apparent jaundice.
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References
Ohi R, Nio M. The jaundice infant: biliary atresia and other obstructions. In: O’Neill JA, Rowe MI, Grosfeld JL, eds. Pediatric surgery. St Louis, MO: Mosby-Year Book, 1998: 1465–1482.
Matsui A, Sasakia N, Arakawa Y, Ishikawa T, Momoya T, Kasano Y, et al. Neonatal mass screening for biliary atresia, a pilot study in Tochigi Prefecture, Japan. Screening 1993;2:201–209.
Gu YH, Yokoyama K, Mizuta K, Tsuchioka T, Kudo T, Sasaki H, et al. Stool color card screening for early detection of biliary atresia and long-term native liver survival: a 19-year cohort study in Japan. J Pediatr 2015;166:897–902.e1.
Nio M, Sasaki H, Wada M, Kazama T, Nishi K, Tanaka H. Impact of age at Kasai operation on short-and long-term outcomes of type III biliary atresia at a single institution. J Pediatr Surg 2010;45:2361–2363.
Superina R, Magee JC, Brandt ML, Healey PJ, Tiao G, Ryckman F, et al. The anatomic pattern of biliary atresia identified at time of Kasai hepatoportoenterostomy and early postoperative clearance of jaundice are significant predictors of transplant-free survival. Ann Surg 2011;254:577–585.
Kasai M, Suzuki M. A new operation for non-correctable biliary atresia: hepatic portoenterostomy. Shujutsu 1959;13:733–739. [In Japanese]
Serinet MO, Wildhaber BE, Broué P, Lachaux A, Sarles J, Jacquemin E, et al. Impact of age at Kasai operation on its results in late childhood and adolescence: a rational basis for biliary atresia screening. Pediatrics 2009;123:1280–1286.
Hsiao CH, Chang MH, Chen HL, Lee HC, Wu TC, Lin CC, et al. Universal screening for biliary atresia using an infant stool color card in Taiwan. Hepatology. 2008;47:1233–1240.
Yoon PW, Bresee JS, Olney RS, James LM, Khoury MJ. Epidemiology of biliary atresia: a population-based study. Pediatrics 1997;99:376–382.
McKiernan PJ, Baker AJ, Kelly DA. The frequency and outcome of biliary atresia in the UK and Ireland. Lancet 2000;355:25–29.
Chardot C, Carton M, Spire-Bendelac N, Le Pommelet C, Golmard JL, Auvert B. Epidemiology of biliary atresia in France: a national study 1986-96. J Hepatol 1999;31:1006–1013.
Nio M, Sasaki H, Wada M, Kazama T, Nishi K, Tanaka H. Impact of age at Kasai operation on short-and long-term outcomes of type III biliary atresia at a single institution. J Pediatr Surg 2010;45:2361–2363.
Shi J, Wu WJ, Pan WH. Clinical treatment and short term follow-up of biliary atreasia. J Clin Pediatr Surgery 2010;9:175–177. [In Chinese]
Mogul D, Zhou M, Intihar P, Schwarz K, Frick K. Cost-effective analysis of screening for biliary atresia with the stool color card. J Pediatr Gastroenterol Nutr 2015;60:91–98.
Schreiber RA, Masucci L, Kaczorowski J, Collet JP, Lutley P, Espinosa V, et al. Home-based screening for biliary atresia using infant stool colour cards: a large-scale prospective cohort study and cost-effectiveness analysis. J Med Screen 2014;21:126–132.
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Kong, YY., Zhao, JQ., Wang, J. et al. Modified stool color card with digital images was efficient and feasible for early detection of biliary atresia—a pilot study in Beijing, China. World J Pediatr 12, 415–420 (2016). https://doi.org/10.1007/s12519-016-0061-7
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DOI: https://doi.org/10.1007/s12519-016-0061-7