Neonatal Hyperbilirubinemia in a Marginalized Population on the Thai-Myanmar Border: a study protocol

Thielemans, Laurence; Trip-Hoving, Margreet; Bancone, Germana; Turner, Claudia; Simpson, Julie A.; Hanboonkunupakarn, Borimas; Hensbroek, Michaël Boele van; Rheenen, Patrick van; Paw, Moo Kho; Nosten, François; McGready, Rose; Carrara, Verena I.

doi:10.1186/s12887-017-0798-8

“…The young postnatal age and the use of capillary blood in the current study may explain the high HCT levels observed 26, 27 . Moreover, delayed cord clamping is regularly practiced at the SMRU clinic according to WHO recommendations 28 resulting in newborns having a median HCT of 59% (IQR, 54-64) at 24 hours of life 29 , a value similar to other settings worldwide 26, 27, 30 .…”

Section: Discussionmentioning

confidence: 99%

Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

Thielemans¹,

Hashmi²,

Priscilla³

et al. 2018

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Background: Screening and monitoring serum bilirubin (SBR) in neonates is crucial to prevent neonatal hyperbilirubinemia (NH)-associated morbidity and mortality worldwide. A lack of resources is often a barrier for measuring SBR in developing countries. Reliable, cost-effective, easy to use point-of-care (POC) SBR tests are needed. This study aimed to evaluate the technical accuracy and usability of the Bilistick System (BS), a new bilirubin POC test, in a tropical setting. Methods: This was a mixed-methods study, including laboratory validation of the BS, direct observation of technical procedures as performed by the midwives and midwives’ assessment of the device’s easiness of use through focus group discussions (FGD) and a self-administered questionnaire. The study was conducted in a field clinic of the Shoklo Malaria Research Unit along the Thailand-Myanmar border between January and December 2017. Results: A total of 173 samples were tested at a median age of 4 days. BS generated an error message—providing no SBR readout—in 48.6% of the tests performed. For the tests that yielded a result, the correlation coefficient (95% CI) between BS and routine laboratory bilirubinometer SBR was 0.87 (0.77-0.93). The accuracy decreased with increasing haematocrit and at higher humidity (≥75%). Direct observation of the operators using the device and analysis of the focus group discussions and questionnaires indicated that the BS was considered easy to use and required limited training. Conclusions: This evaluation showed that the BS, in its current formulation, does not provide reliable results for measuring SBR in a tropical, low-resource setting but has acceptable usability features.

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“…The limitation of high HCT might have been underestimated from this study as neonates with previous HCT >65% were ineligible. Birth cohort 34 data from the same setting suggests the device would not be suitable for up to 1 in 4 neonates with HCT >65% between 2h to 30h of life: capillary Hct was >65% in 17.4% (193/1111) and Hct was ≥70% in 8.4% (93/1111) of the newborns (unpublished data, L. Thielemans).…”

Section: Discussionmentioning

confidence: 97%

“…The young postnatal age and the use of capillary blood in the current study may explain the high HCT levels observed 31 , 32 . Moreover, delayed cord clamping is regularly practiced at the SMRU clinic according to WHO recommendations 33 resulting in newborns having a median HCT of 59% (IQR, 54-64) at 24 hours of life 34 , a value similar to other settings worldwide 31 , 32 , 35 .…”

Section: Discussionmentioning

confidence: 99%

Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

Thielemans¹,

Hashmi²,

Priscilla³

et al. 2018

Self Cite

View full text Add to dashboard Cite

Background: Screening and monitoring serum bilirubin (SBR) in neonates is crucial to prevent neonatal hyperbilirubinemia (NH)-associated morbidity and mortality worldwide. A lack of resources is often a barrier for measuring SBR in developing countries. Reliable, cost-effective, easy to use point-of-care (POC) SBR tests are needed. This study aimed to evaluate the technical accuracy and usability of the Bilistick System (BS), a new bilirubin POC test, in a tropical setting. Methods: This was a mixed-methods study, including laboratory validation of the BS, direct observation of technical procedures as performed by the midwives and midwives’ assessment of the device’s easiness of use through focus group discussions (FGD) and a self-administered questionnaire. The study was conducted in a field clinic of the Shoklo Malaria Research Unit along the Thailand-Myanmar border between January and December 2017. Results: A total of 173 samples were tested at a median age of 4 days. BS generated an error message—providing no SBR readout—in 48.6% of the tests performed. For the tests that yielded a result, the correlation coefficient (95% CI) between BS and routine laboratory bilirubinometer SBR was 0.87 (0.77-0.93). The accuracy decreased with increasing haematocrit and at higher humidity (≥75%). Direct observation of the operators using the device and analysis of the focus group discussions and questionnaires indicated that the BS was considered easy to use and required limited training. Conclusions: This evaluation showed that the BS, in its current formulation, does not provide reliable results for measuring SBR in a tropical, low-resource setting but has acceptable usability features.

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“…The longitudinal design allowed associations between antenatal and postnatal depression to be examined. Finally, given that over 90% of migrant women in this region access antenatal care, we believe that the results are representative of the local migrant population [27].…”

Section: Strengths and Limitationsmentioning

confidence: 88%

Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study

Fellmeth

¹

,

Plugge

²

,

Fazel

³

et al. 2020

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Background: Perinatal depression is a significant contributor to maternal morbidity and mortality globally. Migrant women, particularly those living in low-and middle-income settings, represent a particularly vulnerable group due to stressors experienced before, during and after migration. The vast majority of global migration flows occurring within and between low-and middle-income regions, yet existing evidence focuses predominantly on migrants in high-income destinations. This study aimed to redress this significant gap in the evidence by determining the prevalence and determinants of perinatal depression among migrant women on the Thai-Myanmar border.Methods: A cohort of labour migrant and refugee women was followed-up from the first trimester of pregnancy to one month post-partum. Depression status was assessed in the first, second and third trimesters of pregnancy and at one month post-partum using the Structured Clinical Interview for the Diagnosis of DSM-IV Disorders. Women diagnosed with depression had immediate access to care. Data on potential demographic, social and clinical associated factors was collected using a questionnaire. Prevalence and incidence of any depressive disorder and moderate-severe depressive disorder was calculated. Univariable and multivariable logistic regression using complete case analysis was used to estimate odds ratios (OR) of association between exposure variables and depression status.(Continued on next page)

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Neonatal Hyperbilirubinemia in a Marginalized Population on the Thai-Myanmar Border: a study protocol

Cited by 11 publications

References 26 publications

Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

Prevalence and determinants of perinatal depression among labour migrant and refugee women on the Thai-Myanmar border: a cohort study

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