The Newborn Screening Society of the Philippines, Inc. (NSSPI) and the University of the Philippines (UP) Manila, through the Newborn Screening Reference Center (NSRC), virtually kicked off the 19th National Newborn Screening Convention on Tuesday, October 5, 2021, with the theme: “Towards a Smart Expanded Newborn Screening Program.”

The three-day event, coinciding with the observance of the Newborn Screening Week by virtue of Presidential Proclamation No. 540, weaved together talks on the basics of expanded newborn screening, ethics and legal issues, updates and innovations, and efforts for digital transformation along with stories from different program implementers on successfully carrying through the newborn screening services in the middle of the pandemic.

Around 7,300 registered health professionals, advocates, researchers, and program partners were in attendance, led by NSSPI President Dr Rizalina Racquel Gonzalez and NSRC Director Noel Juban, who welcomed the participants and opened the convention, respectively. Gonzales shared to the attendees the range of topics to be expected including the exceptional performance of program implementers to provide newborn screening services despite the challenges of the current times. Juban commended all the strategies and the best practices made during the pandemic situation through the use of digital platforms, online databases, automation, and the mapping of diseases for efficient service delivery. As in the previous years, nurses comprised the biggest number of attendees, followed by midwives and medical technologists. They were joined by physicians, nutritionists, and chemists.

Department of Health (DOH) Undersecretary Rosario Vergeire delivered the keynote address, and walked the participants through the history of the newborn screening from being a pilot project in 1996 to its eventual incorporation into the roster of DOH-led programs. Vergeire commended the program implementers and other stakeholders for their ability to cope and adjust amid the challenges brought about by the pandemic.

“A Smart Expanded Newborn Screening does not have to refer to advanced technologies and high-level devices but a theme that is geared towards one mission, that is to ensure that all Filipino children will have access to and will avail of total quality care for optimal growth and development of their full potential. This theme, as we stood in the pandemic and natural disasters, yet this program continues to prosper and save Filipino newborns since 1996,” said Vergerie as she set the tone of the annual convention.

The three-day event featured five pre-convention lectures on the basics of expanded newborn screening (ENBS) and the main convention’s 12 plenary sessions covering pertinent issues and updates in screening programs.

Pre-convention resource persons and experts included Dr Sylvia C. Estrada, Short-Term Follow-up National Coordinator; Dr Ma. Paz Virginia K. Otayza, Newborn Screening Center – Northern Luzon Unit Head; Dr Bernadette Halili-Mendoza, Newborn Screening Center-Central Luzon Unit Head; Dr Alma M. Panganiban-Andal, Newborn Screening Center-Southern Luzon Unit Head; and Dr Anna Lea G. Elizaga, Newborn Screening Center-National Institutes of Health Unit Head.

The speakers provided information on the corresponding topics: The Philippine Newborn Screening Program, Overview of the ENBS Disorders, Proper Dried Blood Spot Collection, Timeliness of Newborn Screening, and Short-Term and Long-Term Follow up Care. They underscored the importance of effective communication, timeliness of screening, confirmatory, assessment, and management or treatment of the affected newborns.

Panelists on Day 1 of the main convention discussed the modernization of the newborn screening services in the country, value of disease mapping, improvement in the accessibility of patient care services in the grassroots, linkages, handling results, and advancing nutritional therapy for patients.

SMART System, Other Updates

In the first two plenary sessions, UP Manila Chancellor Dr Carmencita Padilla and NSRC Program Support Unit Head Ma Elouisa Reyes announced that the Philippine Newborn Screening Program is now phasing towards a SMART system, which is expected to facilitate faster access to information to ensure improved and timely program monitoring and better allocation of resources. This can also help program implementers to plan on improving the service delivery of the program.

In Plenary 3, Dr Leniza Hamoy announced the start of operations of the Centers for Human Genetics Services or CHGS in each major island group. The CHGS will facilitate the comprehensive clinical management and genetic counseling services for families and individuals, and serve as the central repository of medical foods and treatment needs.

Dr Renilyn Reyes, head of the public health program development cluster of DOH-Center for Health Development Western Visayas, and Dr Karen Ventilacion, the head of the continuity clinic in Western Visayas presented in Plenary 4 the operations of the Newborn Screening Continuity Clinics and establishment of Satellite Clinics in strategic provinces. They stressed that the real challenge is sustaining, constantly innovating, and continuously engaging all health partners for this endeavor – from patients’ parents to policymakers.

In photo (L-R): J Edgar Winston Posecion, NSSPI Secretary; Dr Renilyn Reyes, DOH-Center for Health Development Western Visayas Program Manager; Dr Karen Ventilacion, Continuity Clinic in Western Visayas Medical Specialist; and Dr Leniza Hamoy, Centers for Human Genetics Services Head

In Plenary 5, Dr Cynthia Feliciano, pediatric endocrinologist, Dr Reynaldo de Castro, Jr., pediatric hematologist, and Dr Mary Anne Chiong, clinical geneticist and metabolic specialist, discussed how to deal with false positive and false negative results given six sample cases presented by Dr Michelle Abadingo. They all stressed the important considerations in interpreting newborn screening results such as prematurity and liver dysfunction.

In Plenary 6, Dr Juliet Sio-Aguilar, pediatric gastroenterologist, presented her group’s descriptive and cross-sectional research on “Advancing Nutritional Therapy for Patients with Inborn Errors of Metabolism (IEMs) in the Philippines.” The research investigates the biochemical and nutritional content of 30 commonly used food products in the local setting.

Ethical and Legal Issues

Part of the NSSPI and NSRC’s commitment was providing continuing education in the broad aspects of patient care. Thus, special to this year’s annual convention was a session on the ethical and legal issues of telemedicine in newborn screening in Plenary 7. Dr Mary Ann Abacan, geneticist, and Atty James Dennis Gumpal, Chief Legal Counsel of UP Manila, presented their views on three case scenarios of telemedicine consultations. Abacan highlighted that the core of telemedicine is the physician-patient relationship, which is based on trust and safeguarding patient confidentiality. Gumpal tackled the legal perspectives, such as the provisions in the Data Privacy Act and the basis for physician-patient relationships.

In photo (L-R): Dr. Lorna Abad, NSSPI Board of Trustee; Dr Mary Ann Abacan, Chair of the Expert Committee on Metabolic Disorders; and Atty James Dennis Gumpal, Chief Legal Counsel of UP Manila

Dr Eva Maria C. Cutiongco - de la Paz, UP National Institutes of Health Executive Director, presented data from operations research in Plenary 8. The study is being conducted to identify and confirm true positive cases in an inexpensive and timely way. In the same plenary, Dr Maria Beatriz Gepte, Experts Committee on Hemoglobinopathies Chair, stated that the Philippines belongs to the Thalassemia belt, a region where the prevalence of Thalassemia ranges from 2.5% to 15%.

PhilHealth Senior Manager Dr Mary Antonette Remonte presented updates and utilization of the PhilHealth’s Newborn Care Package in Plenary 9. More program innovations were presented in Plenary 10: Use of Social Media in Newborn Screening to Inform and Influence by Nikki D. Dela Cruz, Newborn Screening Center Central Luzon Project Development Officer; Continuing NBS Training for the Newborn Screening Facilities Amidst the Pandemic by Dr Janet Miclat, NBS Program Manager of the DOH Central Luzon Center for Health Development; and Acknowledging the Role of Dietitians in the Management of Patients in the NBS Continuity Clinic by Dominga L. Dawe, Dietitian at the CAR Newborn Screening Continuity Clinic.

In Plenary 11, Adolescent Medicine Specialist Dr Margaret Mae Maaño, emphasized that collaboration is essential in the process of health care transition from pediatrics to adult care.

Other Screening Programs

The last plenary featured other screening programs in children, specifically Newborn Hearing Screening, Pulse Oximeter Screening for Critical Congenital Heart Disease, and Vision Screening presented by UP College of Medicine Dean Charlotte Chiong, UP-PGH Program Director Dr Jose Jonas D. del Rosario, and Philippine Eye Research Institute Director Dr Leo Cubillan, respectively.

In photo (L-R): Dr. Lorna Abad, NSSPI Board of Trustee; Dr Margaret Mae Maaño, consultant from the UP-PGH Division of Adolescent Medicine; Charlotte Chiong, Dean of the UP College of Medicine; Dr Jose Jonas D. del Rosario, UP-PGH Program Director; and Dr Leo Cubillan, Director of the Philippine Eye Research Institute

The newborn screening program implementers continue to make good progress in addressing the key needs to adapt to changes, not just in technology but in the constantly changing health environment. As always, the national convention and the celebration of the National Newborn Screening Week were excellent opportunities to update the newborn screening community on the progress, challenges, and success stories, and to maintain commitment to the shared vision of saving Filipino newborns from death and mental retardation. #

First published on Philippine Star, October 17, 2021