Modified stool color card with digital images was efficient and feasible for early detection of biliary atresia-a pilot study in Beijing, China.
BACKGROUND
The aim of this pilot study in Beijing, China, was to validate a screening system for early detection of biliary atresia (BA) by using a modified version of the stool color card (SCC).


METHODS
From 2013 to 2014, a total of 29 799 live born infants were screened. SCC was distributed in maternal facilities. Guardians were asked to check their infants' stool colors daily using SCC up until four months after birth. The screening results among 92.5% of participants were reported. Cases deemed as high risk were referred to a surgical department immediately.


RESULTS
Based on the results reported by the guardians, 24 infants showed pale-pigmented stools, of which two males without obvious signs of jaundice were diagnosed with BA at 52 and 55 days of age, respectively. The sensitivity was 100% and specificity was 99.9%. Four infants were confirmed as having other diseases. Two female patients failed to be screened by the SCC because they had severe jaundice and were referred to the Neonatal Intensive Care Unit after birth. They were diagnosed as BA at 14 and 17 days after birth, respectively. The overall prevalence of BA in this study was 1.3 in 10 000 live births.


CONCLUSIONS
The modified SCC was effective and feasible for early detection of BA, especially for patients with no apparent jaundice.
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Yuan-Yuan
YY
Kong
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Jin-Qi
JQ
Zhao
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Jie
J
Wang
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Lei
L
Qiu
Department of Newborn Screening, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.
Hai-He
HH
Yang
Department of Surgery, Capital Institute of Pediatrics, Beijing, China.
Mei
M
Diao
Department of Surgery, Capital Institute of Pediatrics, Beijing, China.
Long
L
Li
Graduate School of Public Health, Teikyo University, Tokyo, Japan. gyh@med.teikyo-u.ac.jp.|Department of Hygiene and Public Health, Teikyo University, Tokyo, Japan. gyh@med.teikyo-u.ac.jp.
Yan-Hong
YH
Gu
National Medical Center for Children and Mothers, National Center for Child Health and Development, Tokyo, Japan.
Akira
A
Matsui
D000068476:Beijing; D001656:Biliary Atresia / Q000175:diagnosis*; D002681:China; D015331:Cohort Studies; D003116:Color; D003955:Diagnostic Tests, Routine / Q000379:methods*; D042241:Early Diagnosis; D005243:Feces / Q000737:chemistry*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis*; D008297:Male; D015997:Neonatal Screening / Q000379:methods; D010865:Pilot Projects; D011247:Pregnancy; D012680:Sensitivity and Specificity
Kasai procedure; early detection; jaundice; sensitivity; specificity