Importance The real prevalence and clinical burden of severe neonatal jaundice are undefined due to difficulties in measuring total serum bilirubin (TSB) outside secondary and tertiary clinical centers. Objective To assess the diagnostic performance of the point-of care Bilistick System (BS) in identifying neonatal jaundice patients requiring treatment. Design Between April 2015 and November 2016, 1911 neonates, were recruited to participate in the study. Blood samples were simultaneously collected for the TSB determination by BS and by hospital laboratory (Lab). Data were collected and sent to the Bilimetrix headquarter in Trieste where statistical analysis was performed. Newborns with neonatal jaundice were treated with phototherapy according to each center's guidelines. Setting 17 hospitals from Nigeria, Egypt, Indonesia, and Viet Nam. Participants 1911 newborns were included, of which 1458 (76·3%) fulfilled the inclusion criteria. Results TSB level measured by BS agreed (p < .0001) with the lab result in all four countries. The diagnostic performance of BS showed a positive predictive value (PPV) of 92·5% and a negative predictive value (NPV) of 92·8%. Conclusions and Relevance BS is a reliable system to detect neonatal jaundice over a wide range of bilirubin levels. Since Bilistick is a point-of-care test, its use may provide appropriate and timely identification of jaundiced newborns requiring treatment.

Gangguan pendengaran pada masa bayi akan menyebabkan gangguan wicara, berbahasa, kognitif, masalah sosial, dan emosional. Identifikasi gangguan pendengaran secara dini dan intervensi yang sesuai sebelum usia 6 bulan terbukti dapat mencegah segala konsekuensi tersebut. The Joint Committee on Infant Hearing tahun 1994 merekomendasikan skrining pendengaran neonatus harus dilakukan sebelum usia 3 bulan dan intervensi telah diberikan sebelum usia 6 bulan. Otoacoustic emissions (OAE) dan/ atau automated auditory brainstem response (AABR) direkomendasikan sebagai metode skrining pendengaran pada neonatus. Pemeriksaan ABR telah dikenal luas untuk menilai fungsi nervus auditorius, batang otak, dan korteks pendengaran. Pemeriksaan OAE sebagai penemuan baru dilaporkan dapat menilai fungsi koklea, bersifat non invasif, mudah dan cepat mengerjakannya, serta tidak mahal. Kata kunci : newborn hearing screening, otoacoustic emissions, auditory brainstem responseP eriode kritis perkembangan pendengaran dan berbicara dimulai dalam 6 bulan pertama kehidupan dan terus berlanjut sampai usia 2 tahun.1 Beberapa faktor risiko pada neonatus perlu diketahui untuk mengindentifikasi kemungkinan adanya gangguan pendengaran kongenital atau didapat bayi dengan gangguan pendengaran bilateral yang diintervensi sebelum usia 6 bulan, pada usia 3 tahun akan mempunyai kemampuan berbahasa normal dibandingkan dengan bayi yang baru diintervensi setelah usia 6 bulan.2-4 Tujuan tulisan ini untuk membahas pentingnya skrining gangguan pendengaran pada neonatus dengan ulasan beberapa cara skrining.

Our study indicated that there was no relationship between aminoglycosides serum trough concentration and ototoxicity in neonates with neonatal sepsis.

Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants. Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented. Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period. Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.