Irradiance Readings of Phototherapy Equipment: Nigeria

Owa, Joshua A.; Adebami, Olusegun J.; Fadero, Folorunso Francis; Slusher, Tina M.

doi:10.1007/s12098-011-0382-4

Cited by 32 publications

(31 citation statements)

References 9 publications

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“…This conclusion is consistent with data worldwide that reveal a shortcoming in our ability to consistently and optimally treat infants with neonatal hyperbilirubinemia [15,17,18,19,20]. …”

Section: Discussionsupporting

confidence: 92%

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area

et al. 2018

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Background: Phototherapy (PT) is widely used to prevent and treat severe hyperbilirubinemia and its associated risks for both acute and chronic bilirubin encephalopathy. Intensive PT, recommended for inpatient treatment of hyperbilirubinemia in term and near-term infants, is defined as having a spectral irradiance of ≥30 μW/cm²/nm. Objectives: We aimed to assess local PT practices by measuring the irradiance of PT devices in local neonatal intensive care units and newborn nurseries. Methods: The irradiance footprint, including maximum irradiance at the center of the footprint, of 39 PT devices in 7 area hospitals was measured according to current practice in these facilities. Results: The mean ± SD (range) footprint irradiance was 20.7 ± 5.8 (8.8-29.4) μW/cm²/nm. The mean ± SD maximum irradiance at the footprint center for all devices at a mean clinically used treatment distance of 33.1 ± 9.3 (25.5-60.0) cm was 27.8 ± 7.0 (14.7-42.0) μW/cm²/nm. Sixty-two percent of the devices did not meet the minimum recommended spectral irradiance for intensive PT. For the sites without irradiance-based protocols, the maximum irradiance of the devices (n = 33) at the treatment distances was 25.8 ± 6.1 μW/cm²/nm. Conclusions: Despite established PT guidelines, local protocols and practices vary. Based on an assessment of 7 local hospitals, intensive PT was suboptimal for 62% of devices. Straightforward changes, such as decreasing the distance between an infant and the light source and establishing a consistent irradiance-based protocol, could substantially improve the quality of the intervention.

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“…This conclusion is consistent with data worldwide that reveal a shortcoming in our ability to consistently and optimally treat infants with neonatal hyperbilirubinemia [15,17,18,19,20]. …”

Section: Discussionsupporting

confidence: 92%

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area

et al. 2018

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“…Severe NNJ and kernicterus remain highly prevalent and continue to be associated with a high CFR [20,37,38,39,40,41,42,43,44,45,46]. …”

Section: Nnj In Selected African Countriesmentioning

confidence: 99%

“…The lack of effective phototherapy units, especially those capable of providing intensive irradiance (>30 µW/cm 2 ), contributes to the incidence of severe NNJ [1,45,79,80,81]. A recent report described a canopy for providing filtered-sunlight phototherapy, which was found to be effective in reducing TSB in infants with mild-to-moderate hyperbilirubinemia [70].…”

Section: The Present and The Future In Preventing Serious Nnjmentioning

confidence: 99%

Neonatal Jaundice in Low- and Middle-Income Countries: Lessons and Future Directions from the 2015 Don Ostrow Trieste Yellow Retreat

Greco¹,

et al. 2016

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Severe neonatal hyperbilirubinemia, defined as total serum bilirubin (TSB) ≥20 mg/dl, is associated with a higher risk of permanent neurological sequelae and death. Jaundice can and should be promptly diagnosed and treated. Reliable methods for TSB assay are not always readily available, particularly in low- and middle-income countries, making the true incidence of severe neonatal jaundice (NNJ) difficult to estimate. To gather a more comprehensive picture, a symposium addressing NNJ worldwide was organized during the 2015 Don Ostrow Trieste Yellow Retreat. Data collected by several researchers in different regions of the world were presented and differences/similarities discussed. This report points out the need for: (1) a coordinated worldwide effort to define the burden and the causes of severe NNJ and its consequences; (2) aggressive educational programs for families and health personnel to facilitate timely care-seeking, and (3) accurate diagnostics and effective phototherapy.

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“…6,7 In Nigeria, even the advent of locally fabricated PT units to increase availability and accessibility has not effectively improved treatment of neonatal jaundice, as most such units provided suboptimal irradiance levels. 6,7 Historically, the use of conventional, electrically powered PT lamps had its origin from the observation by Sister Ward in England that direct sunlight bleached jaundiced premature infants. She reported this to Dr Cremer, who subsequently conducted a small study and verified a reduction in serum bilirubin levels in infants exposed to sunlight for 2 to 4 hours.…”

Section: (Continued On Last Page)mentioning

confidence: 99%

Safety and Efficacy of Filtered Sunlight in Treatment of Jaundice in African Neonates

2014

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Phototherapy effectively treats unconjugated hyperbilirubinemia. However, in resourcepoor settings, functional phototherapy devices are often unavailable due to financial constraints or erratic electrical power availability.WHAT THIS STUDY ADDS: Filtered-sunlight phototherapy could be a cost-effective option in resource-poor settings with abundant sunlight. abstract OBJECTIVES: Evaluate safety and efficacy of filtered-sunlight phototherapy (FS-PT).METHODS: Term/late preterm infants #14 days old with clinically significant jaundice, assessed by total bilirubin (TB) levels, were recruited from a maternity hospital in Lagos, Nigeria. Sunlight was filtered with commercial window-tinting films that remove most UV and significant levels of infrared light and transmit effective levels of therapeutic blue light. After placing infants under an FS-PT canopy, hourly measurements of axillary temperatures, monitoring for sunburn, dehydration, and irradiances of filtered sunlight were performed. Treatment was deemed safe and efficacious if infants were able to stay in FS-PT for $5 hours and rate of rise of TB was ,0.2 mg/dL/h for infants #72 hours of age or TB decreased for infants .72 hours of age. RESULTS:A total of 227 infants received 258 days of FS-PT. No infant developed sunburn or dehydration. On 85 (33%) of 258 treatment days, infants were removed briefly from FS-PT due to minor temperaturerelated adverse events. No infant met study exit criteria. FS-PT was efficacious in 92% (181/197) of evaluable treatment days. Mean 6 SD TB change was -0.06 6 0.19 mg/dL/h. The mean 6 SD (range) irradiance of FS-PT was 38 6 22 (2-115) mW/cm KEY WORDS newborn jaundice, hyperbilirubinemia, sunlight, phototherapy, irradiance, UV, IR, low-middle income countries ABBREVIATIONS AAP-American Academy of Pediatrics ABT-axillary body temperature FS-PT-filtered-sunlight phototherapy PT-phototherapy TB-total serum/plasma bilirubin Dr Slusher conceptualized and designed the study, approved the design and implementation of the study, coordinated and supervised data collection, drafted the initial manuscript, and critically reviewed and revised the manuscript; Dr Vreman contributed to the design of the study and took responsibility for the selection of the films, design, procurement and building of the treatment canopies, and also critically reviewed and revised the draft manuscript; Dr Olusanya approved the design and implementation of the study, coordinated and supervised data collection, and critically reviewed and revised the manuscript; Mr Wong and Dr Stevenson contributed to the design of the study, participated in the film-selection studies, and critically reviewed and revised the draft manuscript; Dr Brearley served as the statistician for the study, and critically reviewed and revised the manuscript; Dr Vaucher contributed to study design, data analysis, and manuscript preparation, and also critically reviewed and revised the manuscript; and all authors approved the final manuscript as submitted.(Continued on...

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Irradiance Readings of Phototherapy Equipment: Nigeria

Cited by 32 publications

References 9 publications

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area

Variation in the Phototherapy Practices and Irradiance of Devices in a Major Metropolitan Area

Neonatal Jaundice in Low- and Middle-Income Countries: Lessons and Future Directions from the 2015 Don Ostrow Trieste Yellow Retreat

Safety and Efficacy of Filtered Sunlight in Treatment of Jaundice in African Neonates

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