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Licensed Unlicensed Requires Authentication Published by De Gruyter April 29, 2020

Pilot study for cystic fibrosis neonatal screening: the Cuban experience

Elisa M. Castells, Aramis Sánchez, Amarilys Frómeta, Yanin Mokdse, Nelson Ozunas, Tania Licourt, Ana Luisa Arteaga, Eladio Silva, Teresa Collazo, Fidel Rodríguez, Odalys Martín, Maryeris Espinosa, Lesley del Río, Pedro L. Pérez, Greilys Morejón, Claudia Almira, Zoe Núñez, Antonio Melchor and Ernesto Carlos González

Abstract

Background

In Cuba, no screening program for cystic fibrosis (CF) has been implemented yet. The ultramicro enzyme-linked immunosorbent assay (UMELISA)® TIR NEONATAL has been developed for the measurement of immunoreactive trypsin (IRT) in dried blood spots on filter paper. The analytical performance of the kit was evaluated in the national network of laboratories.

Methods

Newborn dried blood samples (DBS) were evaluated in 16 laboratories. An IRT/IRT/DNA protocol was followed using a cut-off value of 50 ng/mL. The mean, median and percentiles of the distribution were calculated and a two-sample t-test with unequal variance was used for statistical analysis. Influence of perinatal factors on IRT levels was analyzed.

Results

From January to June 2018, 6470 newborns were studied, obtaining a mean IRT value of 12.09 ng/mL (ranging 0–358 ng/mL) and a median of 8.99 ng/mL. Fifty-two samples (0.78%) were above the cut-off level and 16 samples (0.24%) were elevated in the re-screening process. One of them was confirmed positive by molecular biology (phe508del/c.3120 + 1G > A), constituting the first newborn screened and diagnosed early in Cuba. Second DBS samples were collected on average at 14 days and processed in the laboratory at 16 days of birth. Significant differences were observed (p < 0.05) when evaluating the influence of gender, birth weight (BW) and gestational age (GA) on the IRT values. Lower IRT concentrations were found in samples processed after 10 days of collection.

Conclusions

The performance of UMELISA® TIR NEONATAL in the laboratories has been satisfactory; hence CF newborn screening (NBS) was extended throughout the country from January 2019.

Acknowledgments

We thank Lic. José Luis Fernández Sierra for his valuable help in the final language revision of the manuscript.

  1. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  2. Research funding: None declared.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was approved by the Ethical Committee of the Ministry of Public Health in conjunction with the National Association of CF doctors.

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Received: 2020-01-13
Accepted: 2020-03-28
Published Online: 2020-04-29
Published in Print: 2020-10-25

©2020 Walter de Gruyter GmbH, Berlin/Boston

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