A Novel Icterometer for Hyperbilirubinemia Screening in Low-Resource Settings

Lee, Anne C C; Folger, Lian; Rahman, Mahdia; Ahmed, Salahuddin; Bably, Nazmun Nahar; Schaeffer, Lauren E.; Whelan, Rachel; Panchal, Pratik; Rahman, Sayedur; Roy, Arun Dutta; Baqui, Abdullah H

doi:10.1542/peds.2018-2039

Cited by 27 publications

(26 citation statements)

References 21 publications

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“…Surprisingly, in their study, there was a tendency to overestimate jaundice in dark-skinned children and to underestimate it in fair-skinned children [30]. Several methods attempted to increase the sensitivity and specificity of visual assessment of jaundice in order to be utilized in low-income countries, such as the two-color Bilistrip and the six-color Bili-Ruler [31][32][33]. Currently, in the era of smartphones, different applications for detecting jaundice are being developed such as the BiliCam [34].…”

Section: Discussionmentioning

confidence: 98%

Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

Shash

AlKhater

2021

Children

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Recommendations for the screening of hemolytic disease of the newborn (HDN) advise taking a selective approach in using the direct antiglobulin test (DAT) for mothers with blood group O or RhD-negative. This study assessed the relation of DAT results to maternal and neonatal blood groups and evaluated the risk of HDN. A retrospective analysis of all healthy newborns admitted during 2018 was performed. Of 1463 newborns, 4.4% had a positive DAT. There were 541 (37%) maternal–neonatal pairs with ABO incompatibility, most commonly born to mothers with blood group O. The cohort of neonates born to mothers with blood group O was divided into three groups: the O-A and O-B groups and the O-O group as a control. The DAT was positive in 59 (8.3%) neonates; most were in the O-B group (49.2%), whereas 13.6% were in the control group (p < 0.01). While the neonates in the O-B group were more likely to require phototherapy (p = 0.03), this finding was not related to DAT results. We found that selective testing of mothers with blood group O, mothers with blood group O or RhD-negative, neonates with blood group B, and neonates with blood group B born to mothers with blood group O or RhD-negative was ineffective in detecting phototherapy requirements. Our results indicate no difference regarding the need for phototherapy in neonates born to mothers with different blood types regardless of the DAT results.

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Section: Discussionmentioning

confidence: 98%

Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

Shash

AlKhater

2021

Children

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“…Early detection at the community and facility levels, effective phototherapy with appropriate wavelength of light with monitoring of serum bilirubin levels can decrease the need for exchange transfusions. Innovative methods for early detection and management of jaundice are also essential [34, 35]. In countries with advanced health care systems, exchange transfusions have become uncommon due to earlier detection of jaundice and effective phototherapy.…”

Section: Discussionmentioning

confidence: 99%

Facility readiness in low and middle-income countries to address care of high risk/ small and sick newborns

Narayanan

Nsungwa-Sabiti

Lusyati

et al. 2019

matern health, neonatol and perinatol

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Background The successful promotion of facility births in low and middle-income countries has not always resulted in improved neonatal outcome. We evaluated key signal functions pertinent to Level II neonatal care to determine facility readiness to care for high risk/ small and sick newborns. Method Facility readiness for care of high risk/ small and sick babies was determined through self-evaluation using a pre-designed checklist to determine key signal functions pertinent to Level II neonatal care in selected referral hospitals in Uganda (10), Indonesia (4) and India (2) with focus on the Sub-Saharan country with greater challenges. Results Most facilities reported having continuous water supply, resources for hand hygiene and waste disposal. Delivery rooms had newborn corners for basic neonatal resuscitation, but few practiced proper reprocessing of resuscitation equipment. Birth weight records were not consistently maintained in the Ugandan hospitals. In facilities with records of birth weights, more than half (51.7%) of newborns admitted to the neonatal units weighed 2500 g or more. Neonatal mortality rates ranged from 1.5 to 22.5%. Evaluation of stillbirths and numbers of babies discharged against medical advice gave a more comprehensive idea of outcome. Kangaroo Mother Care was practiced to varying extents. Incubators were more common in Africa while radiant warmers were preferred in Indian hospitals. Tube feeding was practiced in all and cup feeding in most, with use of human milk at all sites. There were proportionately more certified pediatricians and nurses in Indonesia and India. There was considerable shortage of nursing staff, (worst nurse –bed ratio ranging from 1 to 15 in the day shift, and 1 to 30 at night). There was significant variability in facility readiness, as in data maintenance, availability of commodities such as linen, air -oxygen blenders and infusion pumps and of infection prevention practices. Conclusions Referral neonatal units in LMIC have challenges in meeting even the basic level II requirements, with significant variability in equipment, staffing and selected care practices. Facility readiness has to improve in concert with increased facility births of high risk newborns in order to have an impact on neonatal outcome, and on achieving Sustainable Development Goals 3.2.2. Electronic supplementary material The online version of this article (10.1186/s40748-019-0105-9) contains supplementary material, which is available to authorized users.

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“…USA and Bangladesh, a completely renewed icterometer, the Bili-ruler™, was tested recently in 790 neonates of younger than 28 days to identify jaundice. 19 The Bili-ruler™ has six color strips that were developed by processing digital color photographs of newborn infants with different TSB levels. Bili-ruler™ readings on the nose showed the best correlation with TcB concentrations (r = 0.76) as well as with TSB (r = 0.78).…”

Section: Screening Methods-noninvasive Total Serum Bilirubin Assessmentsmentioning

confidence: 99%

Screening methods for neonatal hyperbilirubinemia: benefits, limitations, requirements, and novel developments

et al. 2021

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Severe neonatal hyperbilirubinemia (SNH) is a serious condition that occurs worldwide. Timely recognition with bilirubin determination is key in the management of SNH. Visual assessment of jaundice is unreliable. Fortunately, transcutaneous bilirubin measurement for screening newborn infants is routinely available in many hospitals and outpatient settings. Despite a few limitations, the use of transcutaneous devices facilitates early recognition and appropriate management of neonatal jaundice. Unfortunately, however, advanced and often costly screening modalities are not accessible to everyone, while there is an urgent need for inexpensive yet accurate instruments to assess total serum bilirubin (TSB). In the near future, novel icterometers, and in particular optical bilirubin estimates obtained with a smartphone camera and processed with a smartphone application (app), seem promising methods for screening for SNH. If proven reliable, these methods may empower outpatient health workers as well as parents at home to detect jaundice using a simple portable device. Successful implementation of ubiquitous bilirubin screening may contribute substantially to the reduction of the worldwide burden of SNH. The benefits of non-invasive bilirubin screening notwithstanding, any bilirubin determination obtained through non-invasive screening must be confirmed by a diagnostic method before treatment.

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A Novel Icterometer for Hyperbilirubinemia Screening in Low-Resource Settings

Cited by 27 publications

References 21 publications

Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

Facility readiness in low and middle-income countries to address care of high risk/ small and sick newborns

Screening methods for neonatal hyperbilirubinemia: benefits, limitations, requirements, and novel developments

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