1. Estie Vermeulen Screening

2. Definition Screening is the organized attempt to detect, among apparently healthy people in the community, disorders or risk factors of which they are unaware, with the intention to treat or do something about it. It is about being proactive rather than reactive.

3. Criteria for instituting a screening programme Diagnoses serious, high prevalence Diagnostic test sensitive, specific, simple and inexpensive, safe and acceptable, safe Facility – effective, acceptable and safe Treatment should be available

4. Validity of a screening test Sensitivity – how good is the test at finding people with a disease Specifity – how good is the test at excluding people without the disease

5. The screening process Needs assessment Set objectives and indicators Planning and preparation – tools Screening process Interpretation of screening results Action – intervention strategies Manage and evaluate

6. Intervention strategy An in-depth assessment with follow up treatment A home programme/work visit Appropriate referral Education Support groups

7. Ethical guidelines Permission/consent Privacy and dignity Screening with no intention to assist should a problem be found Failure to screen once the permission is granted Screening if it is unsafe Discrimination Failure to inform results of screening Failure to solve any additional problems that arose which were not specifically related to the screening process Failure to intervene Failure to follow up