Screening for biliary atresia by infant stool color card in Taiwan

Shan Ming Chen, Mei Hwei Chang, Jung Chieh Du, Chieh Chung Lin, An Chyi Chen, Hung Chang Lee, Beng Huat Lau, Yao Jong Yang, Tzee Chung Wu, Chia Hsiang Chu, Ming Wei Lai, Huey Ling Chen, Shu Fen Wu, Yu Cheng Lin, Lung Huang Lin, Ya Huei Tasi, Wen Terng Lin, Chun Hsien Yu, Shiun Bin Fang, Ching Fing HuangHui Wen Chen, Ming Hua Chen, Wn Hsin Wen, Ming Tzong Cheng, Yu Kung Chou, Te Jen Chen

Research output: Contribution to journalArticlepeer-review

135 Citations (Scopus)


OBJECTIVE. We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan. METHODS. A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet. Parents were then asked to observe their infant's stool color by using this card. The medical staff would check the number that the parents chose according to their infant's stool color at 1 month of age during the health checkup and then send the card back to the stool color card registry center. RESULTS. The average return rate was ∼65.2% (78 184 infants). A total of 29 infants were diagnosed as having BA, and 26 were screened out by stool color card before 60 days of age. The sensitivity, specificity, and positive predictive value were 89.7%, 99.9%, and 28.6%, respectively. Seventeen (58.6%) infants with BA received a Kasai operation within 60-day age period. The estimated incidence of BA in screened newborns was 3.7 of 10 000. CONCLUSIONS. The stool color card was a simple, efficient, and applicable mass screening method for early diagnosis and management of BA. The program can also help in estimating the incidence and creating a registry of these patients.

Original languageEnglish
Pages (from-to)1147-1154
Number of pages8
Issue number4
Publication statusPublished - 2006
Externally publishedYes


  • Biliary atresia
  • Incidence
  • Infant stool color card
  • Kasai operation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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