Parental detection of neonatal jaundice using a low-cost colour card: a multicentre prospective study

Xue, Guochang; Zhang, Huali; Ding, Xin; Xiong, Fei; Liu, Yanhong; Hui, Pei; Zhao, Yong; Yan, Han; Ren, Maozhi; Ma, Chao; Lu, Huiqing; Li, Yanli; Meng, Rui; Xie, Lingjun; Chen, Na; Cheng, Xiufang; Wang, Jiaojiao; Xin, Xu; Wang, Ruifen; Jiang, Qi; Zhang, Mengjie; Liang, Guijuan; Li, Yuanzheng; Kang, Jia-Ning; Zhang, Huimin; Zhang, Yinying; Yuan, Yuan; Li, Yawen; Su, Yinglin; Liu, Junping; Duan, Shanxu; Liu, Qingsheng; Wei, Jing

doi:10.1136/bmjpo-2023-001924

Cited by 3 publications

(2 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The price (around 7,000 USD) represents an initial insurmountable investment for most constrained-resource settings, but other transcutaneous devices might be as accurate and more affordable (24). Other cheaper screening tools have been tested, such as icterometers (25, 26) and phone-based apps (27-29), and when properly evaluated could be used by health workers at birthing centers and in remote settings, and even by parents (30) after discharge from the hospital.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border

Bancone,

Gilder,

Win

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Neonatal hyperbilirubinaemia (NH) is a common problem worldwide and causes morbidity and mortality especially in low-resource settings. Methods: A study was carried out at Shoklo Malaria Research Unit clinics along the Thailand-Myanmar border to evaluate a non-invasive test for diagnosis of NH in a low-resource setting. Performance of transcutaneous bilirubinometer Draäger Jaundice Meter JM-105 was assessed against routine capillary serum bilirubin testing before phototherapy during neonatal care in the first week of life. Results were analysed by direct agreement and by various bilirubin thresholds used in clinical practice. Total serum bilirubin was also measured in cord blood at birth and tested for prediction of hyperbilirubinaemia requiring phototherapy in the first week of life. Results: Between April 2020 and May 2023, 742 neonates born at SMRU facilities were included in the study. A total of 695 neonates provided 1 to 9 capillary blood samples for analysis of serum bilirubin (total 1244 tests) during the first week of life and performance of the transcutaneous bilirubinometer was assessed in 307 neonates who provided 687 paired transcutaneous-capillary blood tests. Bilirubin levels were also measured in 738 cord blood samples. Adjusted values of the transcutaneous bilirubinometer showed excellent agreement with capillary serum bilirubin concentration (intraclass correlation coefficient=0.923) and high sensitivity (>98%) at all clinical thresholds analysed across three years of sampling and multiple users. Concentrations of bilirubin detected in cord blood were not useful in identifying neonates at risk of hyperbilirubinaemia requiring treatment. Conclusions: The transcutaneous bilirubinometer is a reliable tool to screen neonates and identify those needing confirmatory blood testing. Bilirubin concentrations in cord blood are not predictive of hyperbilirubinemia in neonates.

show abstract

Section: Discussionmentioning

confidence: 99%

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border

Bancone,

Gilder,

Win

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…It demonstrated the ability to classify various bilirubin levels, but its accuracy was observed to decrease when dealing with high bilirubin levels. Notably, the diagnostic performance of parents using the JCard was found to be slightly less precise compared to that of pediatricians ( 155 ).…”

Section: Non-invasive Approaches For Jaundice Screening and Their Lim...mentioning

confidence: 95%

Demystifying non-invasive approaches for screening jaundice in low resource settings: a review

Abiha,

Banerjee,

Mandal

2023

Front. Pediatr.

View full text Add to dashboard Cite

All national and international pediatric guidelines universally prescribe meticulous bilirubin screening for neonates as a critical measure to mitigate the incidence of acute bilirubin encephalopathy (ABE) and Kernicterus. The prevailing gold standard for jaundice detection in neonates necessitates invasive blood collection, followed by subsequent biochemical testing. While the invasive procedure provides dependable bilirubin measurements and continues to be the sole gold standard diagnostic method for assessing bilirubin concentration. There exists a pressing need to innovate non-invasive screening tools that alleviate the sampling stress endured by newborns, mitigate iatrogenic anemia, and expedite the turnaround time for obtaining results. The exploration of non-invasive modalities for bilirubin measurements is gaining momentum, driven by the overarching goal of minimizing the number of pricks inflicted upon neonates, thereby rendering screening a swift, efficient, comfortable, and dependable process. This comprehensive review article delves extensively into the array of non-invasive approaches and digital solutions that have been proposed, implemented, and utilized for neonatal bilirubin screening, with a particular emphasis on their application in low-resource settings. Within this context, the review sheds light on the existing methodologies and their practical applications, with a specific focus on transcutaneous bilirubin meters. Moreover, it underscores the prevailing open challenges in this domain and outlines potential directions for future research endeavors. Notably, the review underscores the imperative need for robust educational programs targeted at both families and healthcare personnel to expedite the process of seeking timely care for neonatal jaundice. Additionally, it underscores the necessity for the development of enhanced screening and diagnostic tools that can offer greater accuracy in clinical practice.

show abstract

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border

Bancone,

Gilder,

Win

et al. 2024

bmjpo

View full text Add to dashboard Cite

BackgroundNeonatal hyperbilirubinaemia (NH) is a common problem worldwide and is a cause of morbidity and mortality especially in low-resource settings.MethodsA study was carried out at Shoklo Malaria Research Unit (SMRU) clinics along the Thailand–Myanmar border to evaluate a non-invasive test for diagnosis of NH in a low-resource setting. Performance of a transcutaneous bilirubinometer Dräger Jaundice Meter JM-105 was assessed against routine capillary serum bilirubin testing (with BR-501 microbilirubinometer) before phototherapy during neonatal care in the first week of life. Results were analysed by direct agreement and by various bilirubin thresholds used in clinical practice. Total serum bilirubin was also measured in cord blood at birth and tested for prediction of hyperbilirubinaemia requiring phototherapy in the first week of life.ResultsBetween April 2020 and May 2023, 742 neonates born at SMRU facilities were included in the study. A total of 695 neonates provided one to nine capillary blood samples for analysis of serum bilirubin (total 1244 tests) during the first week of life. Performance of transcutaneous bilirubinometer was assessed in 307 neonates who provided 687 paired transcutaneous capillary blood tests. Bilirubin levels were also measured in 738 cord blood samples. Adjusted values of transcutaneous bilirubinometer showed excellent agreement with capillary serum bilirubin concentration (intraclass correlation coefficient=0.923) and high sensitivity (>98%) at all clinical thresholds analysed across 3 years of sampling and multiple users. Concentrations of bilirubin detected in cord blood were not useful in identifying neonates at risk of hyperbilirubinaemia requiring treatment.ConclusionsThe transcutaneous bilirubinometer is a reliable tool to screen neonates and identify those needing confirmatory blood testing. Bilirubin concentrations in cord blood are not predictive of hyperbilirubinaemia in neonates.

show abstract

Parental detection of neonatal jaundice using a low-cost colour card: a multicentre prospective study

Cited by 3 publications

References 35 publications

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand-Myanmar border

Demystifying non-invasive approaches for screening jaundice in low resource settings: a review

Non-invasive detection of bilirubin concentrations during the first week of life in a low-resource setting along the Thailand–Myanmar border

Contact Info

Product

Resources

About