Published online April 3, 2006
PEDIATRICS Vol. 117 No. 4 April 2006, pp. 1147-1154 (doi:10.1542/peds.2005-1267)

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (16) Citing Articles via Google Scholar Google Scholar Articles by Chen, S.-M. Search for Related Content PubMed PubMed Citation Articles by Chen, S.-M. Related Collections Gastrointestinal Tract Social Bookmarking                         What's this?

Screening for Biliary Atresia by Infant Stool Color Card in Taiwan

Shan-Ming Chen, MD^a,b, Mei-Hwei Chang, MD^a, Jung-Chieh Du, MD^a, Chieh-Chung Lin, MD^c, An-Chyi Chen, MD^d, Hung-Chang Lee, MD^e, Beng-Huat Lau, MD^f, Yao-Jong Yang, MD^g, Tzee-Chung Wu, MD^h, Chia-Hsiang Chu, MDⁱ, Ming-Wei Lai, MD^j, Huey-Ling Chen, MD, PhD^a the Taiwan Infant Stool Color Card Study Group

^a Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
^b Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan
^c Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan
^d Department of Pediatrics, China Medical University Hospital, Taichung, Taiwan
^e Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
^f Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
^g Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
^h Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan
ⁱ Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Hualien, Taiwan
^j Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan

OBJECTIVE. We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan.

METHODS. A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet. Parents were then asked to observe their infant's stool color by using this card. The medical staff would check the number that the parents chose according to their infant's stool color at 1 month of age during the health checkup and then send the card back to the stool color card registry center.

RESULTS. The average return rate was 65.2% (78184 infants). A total of 29 infants were diagnosed as having BA, and 26 were screened out by stool color card before 60 days of age. The sensitivity, specificity, and positive predictive value were 89.7%, 99.9%, and 28.6%, respectively. Seventeen (58.6%) infants with BA received a Kasai operation within 60-day age period. The estimated incidence of BA in screened newborns was 3.7 of 10000.

CONCLUSIONS. The stool color card was a simple, efficient, and applicable mass screening method for early diagnosis and management of BA. The program can also help in estimating the incidence and creating a registry of these patients.

---

Key Words: biliary atresia • infant stool color card • incidence • Kasai operation

Abbreviations: BA—biliary atresia • NH—neonatal hepatitis

---

Accepted Sep 1, 2005.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				M.-O. Serinet, B. E. Wildhaber, P. Broue, A. Lachaux, J. Sarles, E. Jacquemin, F. Gauthier, and C. Chardot Impact of Age at Kasai Operation on Its Results in Late Childhood and Adolescence: A Rational Basis for Biliary Atresia Screening Pediatrics, May 1, 2009; 123(5): 1280 - 1286. [Abstract] [Full Text] [PDF]

				S. I. Wadhwani, Y. P. Turmelle, R. Nagy, J. Lowell, P. Dillon, and R. W. Shepherd Prolonged Neonatal Jaundice and the Diagnosis of Biliary Atresia: A Single-Center Analysis of Trends in Age at Diagnosis and Outcomes Pediatrics, May 1, 2008; 121(5): e1438 - e1440. [Abstract] [Full Text] [PDF]

				D. A Kelly and M. Davenport Current management of biliary atresia Arch. Dis. Child., December 1, 2007; 92(12): 1132 - 1135. [Abstract] [Full Text] [PDF]