Home‐use icterometry in neonatal hyperbilirubinaemia: <scp>C</scp>luster‐randomised controlled trial in <scp>V</scp>ietnam

Luu, Mitchell N; Le, Loc Tuan; Tran, Bich Huu; Duong, T; Nguyen, Ha Thi Thu; Le, Vui Thi; Partridge, John Colin

doi:10.1111/jpc.12611

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…Simple-to-use and cost-effective tools to assist mothers to detect jaundice in their newborns in home-settings well before the early symptoms of ABE are currently under development in LMICs. [74][75][76] Routine screening and monitoring for G6PD deficiency as well as Rh disease sensitisation should be emphasised especially in LMICs, more so as Rh disease has been successfully eliminated in developed countries.…”

Section: Primary Preventionmentioning

confidence: 99%

Neonatal hyperbilirubinaemia: a global perspective

Olusanya

Kaplan

Hansen

2018

The Lancet Child & Adolescent Health

216

195

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Hyperbilirubinaemia, presenting as jaundice, is a ubiquitous and frequently benign condition in newborn babies but is a leading cause of hospitalisation in the first week of life. In some infants jaundice can become severe, progressing to acute bilirubin encephalopathy and kernicterus with a substantial risk of neonatal mortality and long-term neurodevelopmental impairments. Severe hyperbilirubinaemia and its sequelae continue to occur in industrialised countries with functioning medical systems and a disproportionately high burden also persists in low-income and middle-income countries due primarily to delays in delivering effective treatments that are routinely available in high-income countries. In this Review we summarise up-to-date evidence on the epidemiology of neonatal jaundice including its global burden based on estimates of its prevalence, and both fatal and non-fatal health outcomes. We also discuss the management of severe hyperbilirubinaemia including the prevention of kernicterus, and highlight future directions for research.

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Section: Primary Preventionmentioning

confidence: 99%

Neonatal hyperbilirubinaemia: a global perspective

Olusanya

Kaplan

Hansen

2018

The Lancet Child & Adolescent Health

216

195

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“…Several studies used ≥3 cut-off on Ingram icterometers for identifying neonates with significant jaundice [12,28,30,32]. The corresponding mean TSB for this cut-off value in most studies was approximately 10 mg/dL, which is comparable to the mean TcB of 10 mg/dL and mean TSB of 11mg/dL for color B.…”

Section: Discussionmentioning

confidence: 93%

“…Improved maternal knowledge does not always translate into improved care-seeking practices for neonatal jaundice. Nonetheless, several studies have demonstrated that maternal education has favorable impact on maternal recognition and care-seeking practices for neonatal jaundice [12,25,29,34]. Better understanding and empowerment will likely prevent most mothers from overlooking the potential risks of untreated or lately treated significant jaundice such as mortality and life-long disability in otherwise healthy newborns.…”

Section: Discussionmentioning

confidence: 99%

“…Firstly, it was hospital-based, which may limit its generalizability at the population level. Secondly, the Bilistrip™ was specifically designed for use on the infant’s nose, as reported for Ingram icterometers in other studies [11,12,14,28,29,32]. We were therefore, unable to compare outcomes from different test sites on the infant’s body such as forehead, cheek, gum or sternum.…”

Section: Discussionmentioning

confidence: 99%

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Maternal detection of neonatal jaundice during birth hospitalization using a novel two-color icterometer

et al. 2017

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BackgroundMothers are frequently the first to observe the onset of jaundice in their newborn infants before the decision to seek treatment. However, simple-to-use tools that could facilitate early detection of jaundice and assist mothers to seek professional care, especially after hospital discharge, are rare. This study therefore, set out to evaluate the performance of a -two-color icterometer (Bilistrip™) as a possible screening tool for detecting significant jaundice by mothers or care-givers in the first week of life.MethodsPrior to discharge, mothers in a maternity hospital were trained to use the Bilistrip™ on the blanched skin of their baby’s nose to ascertain absence (Light Yellow) or presence (Dark Yellow) of significant jaundice. Their babies had transcutaneous bilirubin (TcB) measurements independently, along with total serum bilirubin (TSB) if indicated. The reliability of Bilistrip™ as a screening test for significant jaundice was determined at different TcB and TSB thresholds. The predictive performance of Bilistrip™ was also evaluated with multivariable logistic regression.ResultsSome 2492 mother-infant pairs were enrolled over 15 months, of which 347 (13.9%) chose Dark Yellow. The mean TcB for Dark Yellow (10mg/dL) was significantly higher (p<0.001) than for Light Yellow (6.1mg/dL). Bilistrip™ showed increasing sensitivity (47.0% - 92.6%) and negative predictive value (NPV) (91.4% - 99.9%) for selected TcB thresholds (≥10mg/dL, ≥12mg/dL, ≥15mg/dL, and ≥17mg/dL). Among neonates with TSB measurements (n = 124), Bilistrip™ was associated also with increasing sensitivity (86.8% - 100%) and NPV (62.5% - 100%). The sensitivity and NPV for detecting neonates requiring phototherapy were 95.8% respectively. Only one of the 24 neonates who required phototherapy was missed by the Bilistrip™.ConclusionsBilistrip™ is a potential decision-making tool for empowering mothers to detect neonates with clinically significant jaundice that may require close monitoring or treatment, and neonates not requiring treatment for jaundice in the first week of life.

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“…It is still used as a screening tool for jaundice in LMICs. Since then, icterometers have been studied as a possible predictor of significantly elevated serum bilirubin and thus risk for SNJ ( 47 , 48 ). A two-color icterometer was studied in Lagos, Nigeria, with mothers assessing the color of their newborns nose (blanched skin) and comparing to either light yellow (non-significant jaundice) vs. dark yellow (significant jaundice) and validating these assessments against either a TcB or TSB ( 49 ).…”

Section: Advancementsmentioning

confidence: 99%

Management challenges in the treatment of severe hyperbilirubinemia in low- and middle-income countries: Encouraging advancements, remaining gaps, and future opportunities

Satrom

Farouk²,

Slusher³

2023

Front. Pediatr.

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Neonatal jaundice (NJ) is common in newborn infants. Severe NJ (SNJ) has potentially negative neurological sequelae that are largely preventable in high resource settings if timely diagnosis and treatment are provided. Advancements in NJ care in low- and middle-income countries (LMIC) have been made over recent years, especially with respect to an emphasis on parental education about the disease and technological advancements for improved diagnosis and treatment. Challenges remain, however, due to lack of routine screening for SNJ risk factors, fragmented medical infrastructure, and lack of culturally appropriate and regionally specific treatment guidelines. This article highlights both encouraging advancements in NJ care as well as remaining gaps. Opportunities are identified for future work in eliminating the gaps in NJ care and preventing death and disability related to SNJ around the globe.

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Home‐use icterometry in neonatal hyperbilirubinaemia: Cluster‐randomised controlled trial in Vietnam

Abstract: In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.

Cited by 9 publications

References 14 publications

Neonatal hyperbilirubinaemia: a global perspective

Neonatal hyperbilirubinaemia: a global perspective

Maternal detection of neonatal jaundice during birth hospitalization using a novel two-color icterometer

Management challenges in the treatment of severe hyperbilirubinemia in low- and middle-income countries: Encouraging advancements, remaining gaps, and future opportunities

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