A pilot programme for the detection of neonatal hypothyroidism in Argentina

The CNEA (Argentine National Atomic Energy Commission) is engaged in a pilot programme with a view to adapting the procedures used in the developing countries, demonstrating the clinical value of mass-scale detection and transferring the methodology developed to medical care centres, where its application could be extended to cover the whole population. For this purpose, the authors selected six zones in Argentina with different geographical and epidemiological characteristics: (1) Greater Buenos Aires, with its stable local population, plus a contribution from the population migrating from within the country; (2) a maritime zone; (3) a north-eastern zone: midland and lowland; (4) a north-western zone; (5) a western zone; (6) a south-western zone; the three last provinces of the Cordillera are classed as endemic goitre zones. The method of detection selected was radioimmunoassay of human thyrotrophic hormone (TSH) in whole blood samples absorbed on paper, using commercial kits designed for neonatal measurement. Statistical studies were made to optimize the time of extraction of the blood sample with allowance for the fact that in the countryside discharge of the new-born child from the hospital frequently occurs within 24 hours. A major percentage of new-born children with suspicious TSH values due to perinatal pathology, through lack of pre-natal care, was observed in the population lacking resources and health insurance. In order to facilitate the follow-up of the hypothyroid children the measurement of thyroid hormones in serum using the RIA laboratories available in each of the regions was initiated. As a result, the pilot programme has brought to light 11 hypothyroids out of the 14,574 new-born babies studied; a very high incidence was observed in the endemic goitre zones