Comparing data from two different areas about screening for DDH. Are our screening strategies still working?

Artid Duni, Vilson Ruci, Julian Ruci

Abstract


Background & Objectives: Screening strategies and structures are difficult to build and maintain especially in developing countries, but once they are installed their outcome should be evaluated and compared. Healthcare structures and staff should continuously monitor and maintain those structures.

To evaluate the outcome and benefits of screening for DDH, comparing the results of early diagnosis in two populations from two different geographic areas. Only in one of them active screening is applied. Also, reporting data about DDH from unscreened populations was another goal of this study.

Methods: In order to evaluate the importance of screening structures and strategies, we compared the incidence of early vs. late diagnosed cases of DDH from a district where active screening (general clinical screening and selective ultrasound) was applied since 2004, with the total population of children treated for DDH in our facility for the 2009-2014 period of time.

Cases treated with soft abduction devices (Pavlik, Mittelmeier, Frejka) were considered as early diagnosed and those treated with hard devices (Ilfield, plaster cast) or surgery as late diagnosed cases. The data were expressed in absolute value and percentage. The Fisher test was used for the statistical analysis and any values of p≤0.05 were considered significant.

Results: A total number of 1712 children with DDH, divided in two populations were studied. Form the 88 children of the population no.1 (the district where active screening was applied), 69 children (78.4%) were diagnosed early and treated with soft abduction devices. In the population no.2, only 627 from 1624 children, (38.6%) were diagnosed early treated with the same devices. (p<0.0001)

Interpretation & Conclusions: The screening strategy definitely produced better results in the district where it was applied. We should activate and maintain a chain of early diagnosis for any congenital pathology countrywide. Even in the areas without any active screening strategy there was observed an increase in the early-detected cases probably due to the reinforcement of the general healthcare system.

 

Key words: DDH, screening strategies, selective ultrasound.


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Copyright (c) 2015 Artid Duni, Vilson Ruci, Julian Ruci

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ISSN 2385-2712         EISSN 2385-2453