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Biliary atresia screening in Shenzhen: implementation and achievements
  1. Jiachen Zheng1,
  2. Yongqin Ye2,
  3. Bin Wang2,
  4. Lihui Zhang3
  1. 1 Shantou University Medical College, Shantou, China
  2. 2 Department of General Surgery, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
  3. 3 Department of Traditional Chinese Medicine, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
  1. Correspondence to Dr Bin Wang, Department of General Surgery, Shenzhen Children's Hospital, Shenzhen, Guangdong, China; szwb1967{at}126.com

Abstract

Objective To elaborate on the implementation and achievements of a biliary atresia (BA) screening programme in Shenzhen.

Methods In 2015, we partnered with the government in Shenzhen and attached the stool colour card (SCC) to the health handbook for mothers and children. These handbooks have been distributed through official channels to every pregnant woman in Shenzhen since 1 January 2015. A total of 118 patients diagnosed with BA at Shenzhen Children’s Hospital were enrolled and divided into two cohorts based on their date of diagnosis: cohort A before and cohort B after introduction of screening. The cohorts were compared to evaluate differences in age at diagnosis, jaundice-free rate, 2-year native liver survival rate and so on.

Results After the implementation of the screening programme, the age at diagnosis decreased from 81±12 to 56±15 days old (p<0.05), the incidence of postoperative complications decreased from 58.8% to 52.6% (p<0.05), the jaundice-free rate increased from 47.1% to 54.4% (p<0.05), and the 2-year native liver survival rate increased from 44.4% to 52.6% (p<0.05). The percentage of patients who underwent surgery increased from 68.0% to 83.8% (p<0.05).

Conclusion In Shenzhen, our screening programme led to earlier diagnoses and better prognoses. The latter resulted in an increased willingness to undergo the Kasai procedure. Through a hospital and government collaboration, this programme exerted a considerable influence, and guardians observed benefits with only a small cost of implementation. Our results may eventually help promote the widespread use of the SCC across the whole country.

  • biliary atresia
  • screening
  • stool colour card
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Footnotes

  • Contributors Study conception and design: JZ, BW. Data acquisition: JZ, BW, LZ. Analysis and data interpretation: JZ, YY. Drafting of the manuscript: JZ. Critical revision: JZ, YY, LZ. Submission of the manuscript: BW.

  • Funding Sanming Project of Medicine in Shenzhen (grant number SZSM201812055).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and approved by the Ethics Committee of Shenzhen Children's Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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