Cost-benefit analysis of G6PD screening in Lebanese newborn males.
BACKGROUND
G6PD deficiency is one of the most prevalent genetic diseases in Lebanon (1% in Lebanese males). Easy and effective screening methods exist to detect this deficiency early in newborns.


OBJECTIVE
To assess the cost-effectiveness of G6PD deficiency screening in the routine work-up of every male newborn in Lebanon.


METHODS
Of 299 babies with G6PD deficiency detected between 1999 and 2004, 139 (46.5%) were located, contacted, and surveyed for their experience of acute anemia crises.


RESULTS
A previous community survey had indicated a 77.8% risk for an acute anemia crisis necessitating hospitalization in unscreened patients, most often associated with consuming fava beans raw or in combination products. In contrast, only 5 (3.8%) of the 139 screened G6PD-deficient babies had ever developed a severe acute anemia crisis. The risk for hospitalization following a crisis had thus been reduced by 95% among patients screened for G6PD deficiency, compared to those unscreened. The estimated mean cost of each hospitalization, which lasts on average 7 days, is 1450 USD. The cost of screening is about 3 USD. The analysis indicates that, given the current prevalence of the deficiency and the reduction in hospitalization rates associated with knowing one's status, the cost of systematic screening is about 2.58 times lower than that of anemia-related hospitalizations in an unscreened population.


CONCLUSIONS
The efficiency of routinely testing evidenced here supports changes in screening policies for boys.
Khneisser
Issam
I
Newborn Screening Laboratory, Medical Genetic Unit, Faculty of Medicine, Saint Joseph University, B.P. 11-5076 Riad El Solh, Beirut, Lebanon. issam.khneisser@usj.edu.lb
Adib
Salim M
SM
Loiselet
Jacques
J
Megarbane
André
A
D000740:Anemia / Q000191:economics; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005236:Favism / Q000191:economics; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000175:diagnosis / Q000191:economics*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D007861:Lebanon; D008297:Male; D015997:Neonatal Screening / Q000191:economics*; D018570:Risk Assessment; D012307:Risk Factors