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

Abstract

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.

Relationship between Glucose 6-Phosphate Dehydrogenase and Pyruvate Kinase Deficiency with New Generation Inflammation Biomarkers of in Term Newborns with Prolonged Neonatal Jaundice

“…Jaundice is frequently mild, self-limiting and generally accepted as physiologic However, some jaundices do not regress as expected and prolonged jaundice may occur [14,15]. There are various factors in the etiology of prolonged jaundice and determination of the cause is important since the treatment, follow-up and prognosis of each of them differ [16,17]. In current study, all patients were breastfed, and 12 patients (7.2%) were also receiving formula.…”

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

“…Most death and disability from NH occur in LMIC, and this loss of healthy life-years is preventable with proper identification and treatment. Together with improved education, there are still measures that can be implemented to improve care for neonatal jaundice in LIMC (32). Better and affordable diagnostics are needed globally (33, 34) and especially in low-resource and conflict areas where clinical care is often dysfunctional.…”

Neonatal jaundice detection in low-resource Mexican settings: possibilities and barriers for innovation with mobile health

“…Equally relevant is training HCWs to carry out VA in a systematic way (supported, for example, with printed charts) and providing more reliable detection tools, such as Picterus JP. There is strong evidence from LMICs that the combination of education and training for HCWs and family members along with access to proper detection and treatment equipment improves the outcomes of newborns affected by NNJ (44).…”