title: Scope and efficiency of the newborn screening program in identifying hemoglobin S.
abstract: BACKGROUND
  In 2001, the Brazilian Ministry of Health added hemoglobinopathies to the National Neonatal Screening Program to be implemented in three steps. In order to meet the proposed goals, it is crucial to establish periodic assessments of this program with the aim of monitoring its implementation.
  
  
  OBJECTIVE
  To assess the scope and the efficiency of the stages of the National Newborn Screening Program in identifying hemoglobin S.
  
  
  METHODS
  A cross-sectional study was developed with the results of the heel prick test using the high performance liquid chromatography method for babies born in Mato Grosso do Sul from 2006 to 2010. The following variables were investigated: year, number of live births, total screening, coverage ratio, prevalence, time between the child birth and the blood collection; age at diagnosis; age at the time of the first consultation; and time between the diagnosis and the first appointment.
  
  
  RESULTS
  Over the five years of the study, the mean coverage rate was 91.77%.The prevalences of hemoglobin FAS and hemoglobin FS were 1.65% and 0.011%, respectively. Blood samples from 43.48% of children were collected from the second to the seventh day. The age at diagnosis was within the first 28 days in 87.80% of the screened children. The lowest mean indices for the first consultation and the time between the diagnosis and the first appointment (58.8 and 46.4 days, respectively) occurred in 2010.
  
  
  CONCLUSIONS
  The scope of the National Neonatal Screening Program for hemoglobinopathies is good, with a large number of individuals being tested. Efficiency is a suitable indicator to assess the program steps. Three points are recommended: the training of the individuals involved, studies to assess the assistance provided to the affected child, and genetic counseling to the mothers.
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Maria Lúcia
authors.initials: ML
authors.lastname: Ivo
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Olinda Maria Rodrigues
authors.initials: OM
authors.lastname: de Araujo
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Barbieri
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Ruy Alberto Caetano
authors.initials: RA
authors.lastname: Corrêa Filho
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Elenir Rose Jardim Cury
authors.initials: ER
authors.lastname: Pontes
authors.affiliation: Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
authors.forename: Carlos Augusto de Oliveira
authors.initials: CA
authors.lastname: Botelho
keywords: Hemoglobin S; Hemoglobinopathies; Neonatal screening