ESPE2015 Poster Category 2 Growth (38 abstracts)
aMU of Varna, Varna, Bulgaria; bVarna Paediatric Endocrine Society (VAPES), Varna, Bulgaria
Background: Many children still miss the early recognition of their stature problems due to inefficient screening strategies.
Objective and hypotheses: To assess stature deviations referral through recruiting general practitioners (GPs) and providing them with tools for easier anthropometric data assessment and enhanced access to the Paediatric Endocrinologist.
Method: Thirty-one general practitioners with a total of 23 058 patients between 218 years were recruited to the Screening program for one year. They were supplied with computer software alerts if patients height, weight or waist circumference (WC) were ≧/±2/SDS. CDC standards for height and weight and WC local data were used as reference. The GPs teams were trained twice on proper anthropometry and on the Screening program protocol. Compliance was checked monthly. Deviating patients were to be referred to a weekly University Screening clinic. At final evaluation GPs were divided into two groups, based on their compliance with the study protocol.
Results: A total of 81 short children (0.35% of all participants and 11.7% of the expected about 3%) were found within 24 478 health check visits with anthropometric measurements. The compliant doctors group found 0.65% short children vs. 0.09% in the non-compliant group. Only 2552 children (11.1%), all from the compliant GPs group, were fully assessed. Among them 1.15% were short and 7.99% were tall (4.78% non-obese). Of all 81 short children 39.5% showed up for further assessment and only 9 agreed to further work-up (4 with constitutional delay in growth and puberty, 3 with syndromic short stature, 2 with GH deficiency). At the same time, 2 GH deficient children from the studied group came to the Clinic through Internet self-found information.
Conclusion: This screening strategy proved as inefficient. The large share of non-attendance and assessment refusal shows that future strategies with media advertising might prove more beneficial.