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PubMed · 15597499

Guthrie test samples: is the problem solved?

Cordelia Thomas
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Abstract

Most babies born in New Zealand have a blood sample taken shortly after birth for the purposes of certain screening tests. The samples are retained indefinitely. This paper considers whether such samples are the property of the child and whether the present changes in the Health (National Cervical Screening Programme) Amendment Bill and the Code of Health and Disability Services Consumers' Rights of 1996 are sufficient to resolve the issues. The paper expresses concern about the delegation of decision-making in this area to ethics committees.

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Anonymous TestingBiological Specimen BanksDatabases, Nucleic AcidEthics Committees, ResearchGenetic PrivacyGenetic ResearchHumansInfant, NewbornInformed ConsentLegislation, MedicalNeonatal ScreeningNew ZealandOwnershipPresumed ConsentBiomedical and Behavioral ResearchGenetics and ReproductionLegal ApproachJournal Article

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Cordelia Thomas. 2004. Guthrie test samples: is the problem solved?. https://pubmed.ncbi.nlm.nih.gov/15597499/

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Masking through averages--intraprovincial heterogeneity in HIV prevalence within the Western Cape.

OBJECTIVE: To measure HIV prevalence at health-district level in the Western Cape (WC) and to compare these findings with those of the National HIV Antenatal Surveys (NHASs). This investigation aimed to estimate the degree of heterogeneity of HIV prevalence within the province in order to inform the design of appropriate and targeted HIV interventions. METHOD: Annual cross-sectional, unlinked district HIV antenatal surveys were implemented in all 25 health districts of the WC for the years 2001 - 2004, concurrently with the NHAS. A stratified proportional sample was drawn for each district, involving all 344 antenatal clinics in the province, and the anonymous screening method as described by the World Health Organization (WHO) was applied. RESULTS: The NHAS revealed a significant increase in HIV prevalence in the WC from 8.6% (95% confidence interval (CI): 5.6 - 11.6) in 2001 to 15.4% (95% CI: 12.5 - 18.2) in 2004. The district-level HIV surveys showed wide variation in HIV prevalence across the health districts, which increased progressively during this period (a range of 0.6 - 22% for the year 2001 increased to 1 - 33% in 2004). Spatial analysis of HIV prevalence by health district for this period also revealed progressive spatial growth of the sub-epidemics, with the highest prevalence observed in districts located in the Cape metropole region. CONCLUSIONS: These concurrent surveys highlight the fact that examining a provincial estimate of HIV prevalence alone has the potential to mask epicentres within the province. This underscores the importance of expanding the surveillance systems to detect heterogeneity sub-provincially, in order to link with local-level planning and resource allocation.

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