(1)In 2002, the Bureau of Health Promotion commissioned Professor Mei-Hwei Chang of the National Taiwan University to develop an indigenously designed infant stool card for use as an economical and effective tool for the early screening of biliary atresia and cholestasis in infants. A patent application for this device was filed with the Ministry of Economic Affairs in December 2003. Substantive examinations are currently underway, and results are expected to be made public in late 2004.
(2)Neonatal jaundice is quite common in Taiwan. While jaundice in most cases disappears within two weeks after birth, some cases continue for longer periods. Among them are infants with cholestasis. It is often mistakenly believed that jaundice in these infants is caused by breastfeeding, resulting in delayed diagnosis or even missing of the treatment window. Cholestasis can be divided into intrahepatic and extrahepatic forms. Biliary atresia is the most common, and most serious, form of extrahepatic cholestasis in infants, and is also the most common fatal liver disease. However, if infants undergo the Kasai operation within 60 days of birth, their prognosis will greatly improve.
(3)Concrete results: From March 2002 to December 2003, the sensitivity of biliary atresia screening increased to 92.5%, and accuracy to 99.9%. Research has shown that in 2002 and 2003, 59.3% of infants with biliary atresia underwent the Kasai operation within 60 days of birth, and that among those that underwent the Kasai operation within 609 days of birth, 81.25% showed jaundice remission. However, among infants with biliary atresia who underwent the Kasai operation more than 60 days after birth, only 40% showed jaundice remission.
The biliary atresia prevalence rate in Taiwan is 2.33-3.35 per 10,000, proving the great importance of early discovery and intervention. In comparison with Western countries, which have a biliary atresia prevalence rate of only 0.67 per 10,000, Taiwans prevalence rate is quite high. This corroborates the past experiences of clinical physicians, and proves that biliary atresia diagnosis, treatment and education are critical tasks in this country.
(4)The stool card has made both parents and medical personnel become more aware of the importance of infant stool color. Nationwide use of the infant stool color identification card can assist in the early screening of biliary atresia and enhance treatment results.