ORIGINAL ARTICLES

Neonatal haemoglobinopathy screening in Belgium

B Gulbis¹, F Cotton¹, A Ferster², O Ketelslegers³, M F Dresse⁴, E Rongé-Collard³, J M Minon³, P Q Lé² and F Vertongen¹

¹ Department of Clinical Chemistry, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
² Department of Hematology/Oncology, Hôpital Universitaire Reine Fabiola, Université Libre de Bruxelles, Brussels, Belgium
³ Laboratory of Hematology, Hôpital de la Citadelle, Liège, Belgium
⁴ Department of Pediatry, CHR de la Citadelle, Université de Liège, Liège, Belgium

Correspondence to:
B Gulbis, Laboratory of Clinical Chemistry, CUB Hôpital Erasme, Route de Lennik 808, 1070 Brussels, Belgium; bgulbis{at}ulb.ac.be

Background: A neonatal haemoglobinopathy screening programme was implemented in Brussels more than a decade ago and in Liège 5 years ago; the programme was adapted to the local situation.

Methods: Neonatal screening for haemoglobinopathies was universal, performed using liquid cord blood and an isoelectric focusing technique. All samples with abnormalities underwent confirmatory testing. Major and minor haemoglobinopathies were reported. Affected children were referred to a specialist centre. A central database in which all screening results were stored was available and accessible to local care workers. A central clinical database to monitor follow-up is under construction.

Results: A total of 191 783 newborns were screened. One hundred and twenty-three (1:1559) newborns were diagnosed with sickle cell disease, seven (1:27 398) with β thalassaemia major, five (1:38 357) with haemoglobin H disease, and seven (1:27 398) with haemoglobin C disease. All major haemoglobinopathies were confirmed, and follow-up of the infants was undertaken except for three infants who did not attend the first medical consultation despite all efforts.

Conclusions: The universal neonatal screening programme was effective because no case of major haemoglobinopathy was identified after the neonatal period. The affected children received dedicated medical care from birth. The screening programme, and specifically the reporting of minor haemoglobinopathies, has been an excellent health education tool in Belgium for more than 12 years.

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