Phenylketonuria screening and management in southeastern Europe – survey results from 11 countries

Mojca Zerjav Tansek, Urh Groselj, Natalija Angelkova, Dana Anton, Ivo Baric, Maja Djordjevic, Lindita Grimci, Maria Ivanova, Adil Kadam, Vjosa Kotori, Hajrija Maksic, Oana Marginean, Otilia Margineanu, Olivera Miljanovic, Florentina Moldovanu, Mariana Muresan, Michaela Nanu, Mira Samardzic, Vladimir Sarnavka, Aleksei Savov, Maja Stojiljkovic, Biljana Suzic, Radka Tincheva, Husref Tahirovic, Alma Toromanovic, Natalia Usurelu, Tadej Battelino

We aimed to assess the current state of PKU screening and management in the region of southeastern Europe. A survey was performed involving all identified professionals responsible for the PKU management in the 11 countries from South-Eastern region of Europe (Albania, Bulgaria, Bosnia and Herzegovina, Croatia, Kosovo, Macedonia, Moldova, Montenegro, Romania, Serbia, Slovenia). The questionnaire was designed to assess the characteristics regarding PKU management in three main areas: nation-wide characteristics, PKU screening, and characteristics of the PKU management in the responding centre. It consisted of 56 questions. The distribution and collection of the questionnaires (via e-mail) was taking place from December 2013 to March 2014. Responses from participants from 11 countries were included; the countries cumulative population is approx. 52.5 mio. PKU screening was not yet introduced in 4 of 11 countries. Reported PKU incidences ranged from 1/7325 to 1/39338 (and were not known for 5 countries). National PKU guidelines existed in 5 of 11 countries and 7 of 11 countries had PKU registry (registries included 40 to 194 patients). The number of PKU centers in each country varied from 1 to 6. Routine genetic diagnostics was reported in 4 of 11 countries. Most commonly used laboratory method to assess phenylalanine levels was fluorometric. Tetrahydrobiopterine was used in only 2 of 11 countries. Most frequently, pediatricians were caring for the patients. Dietitian was a member of PKU team in only 4 of 11 countries, while regular psychological assessments were performed in 6 of 11 countries. Patient's PKU society existed in 7 of 11 countries. The region of southeastern Europe was facing certain important challenges of PKU screening and management. Neonatal PKU screening should be introduced throughout the region. Furthermore, PKU management was falling behind internationally established standards-of-care in many aspects.