Neonatal Jaundice: Knowledge and Practices of Healthcare Providers and Trainees in Southwest Nigeria

Barclay, Eta; Ojo, Ifelayo; Hake, Anne; Oyenuga, Abayomi; Satrom, Katherine M.; Lund, Troy C.; Oyenuga, Mosunmoluwa; Slusher, Tina M.; Gbadero, Daniel

doi:10.4269/ajtmh.21-0588

Cited by 4 publications

(7 citation statements)

References 52 publications

(70 reference statements)

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“…Now decades later after this 1989 recommendation, routine G6PD deficiency screening programs have not been adopted in many regions, even those with a significant burden of G6PD deficiency and SNJ ( 81 ). A recent survey of healthcare providers in Nigeria, one such high risk country, illustrated gaps in knowledge of the common prevalence and need for screening of G6PD deficiency at their local hospital ( 20 ). The combination of routine screening and education of both healthcare workers and parents is needed to reduce the contribution of G6PD deficiency to SNJ globally.…”

Section: Remaining Gapsmentioning

confidence: 99%

“…Arogbokun et al reported that eucalyptus oil induced a 13.4% increase in hemolysis and methylated spirit showed a 39.7% increase in hemolysis in the zebrafish model ( 94 ). A survey of healthcare workers and trainees in Southwest Nigeria demonstrated that even these medical professionals often recommended hemolytic agents for the umbilical cord (82% recommended methylated spirit) ( 95 ). Other regional practices may delay proper care.…”

Section: Remaining Gapsmentioning

confidence: 99%

“…An emphasis on prenatal prevention must include education of the maternal providers, including obstetric physicians, traditional birth attendants, or nurse midwives. A survey of healthcare providers and trainees identified significant gaps in provider knowledge related to prevention of and possible sequela of SNJ ( 20 ). For example only 53% of healthcare providers reported seeing a case of neonatal jaundice and very few traditional birth attendants recognized risk factors for SNJ (G6PD deficiency, Rh incompatibility, preterm birth) ( 20 ).…”

Section: Opportunities For Future Stepsmentioning

confidence: 99%

“…A survey of healthcare providers and trainees identified significant gaps in provider knowledge related to prevention of and possible sequela of SNJ ( 20 ). For example only 53% of healthcare providers reported seeing a case of neonatal jaundice and very few traditional birth attendants recognized risk factors for SNJ (G6PD deficiency, Rh incompatibility, preterm birth) ( 20 ). Risk factors of SNJ that should be identified during pregnancy include a family history of SNJ, Rh negative blood type, family history of G6PD deficiency or other risk factor for hemolysis.…”

Section: Opportunities For Future Stepsmentioning

confidence: 99%

“…There have been noteworthy improvements in the care of infants with NJ over the last years and decades. Significant effort has been made in the prevention of SNJ through parental and healthcare provider education ( 19 , 20 ) and improved diagnosis with more accessible bilirubin measurement tools ( 21 – 25 ). The advent of phototherapy over sixty years ago ( 26 ) with improved quality of devices including the introduction to light emitting diode (LED) based units ( 27 , 28 ), and subsequent upscaling and distribution of this treatment has reduced the need for exchange transfusions and therefore likely improved outcomes ( 29 – 31 ).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

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

Satrom

Farouk²,

Slusher³

2023

Front. Pediatr.

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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.

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Section: Remaining Gapsmentioning

confidence: 99%

Section: Remaining Gapsmentioning

confidence: 99%

Section: Opportunities For Future Stepsmentioning

confidence: 99%

Section: Opportunities For Future Stepsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Satrom

Farouk²,

Slusher³

2023

Front. Pediatr.

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Antenatal jaundice instruction and acute bilirubin encephalopathy in Nigeria

Wennberg,

Imam,

Shwe

et al. 2023

Pediatr Res

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Background Acute Bilirubin Encephalopathy (ABE) is common in Nigeria. Parents’ inability to recognize jaundice and delays in seeking care are significant barriers to its prevention. Methods We compared associations of (1) interactive antenatal maternal jaundice instruction with postnatal reinforcement, (2) standard postnatal instruction, and (3) no maternal instruction with the incidence of ABE among 647 jaundice admissions stratified for risk factors identified in initial descriptive analysis. Results Eighty-three (83/647;12.8%) admissions developed ABE including eleven jaundice-related deaths. ABE was present at admission in 20/22 (90.9%) if mothers received no jaundice instruction and no antenatal care, 42/182 (23.1%) if received antenatal care but no instruction, 16/95 (16.8%) if received postnatal instruction only, and 4/337 (1.2%) if mothers received both antenatal and postnatal instruction (p < .001). ABE was highly associated with out-of-hospital delivery, number of antenatal clinic visits, and birth attendant, but these risks were mitigated by antenatal/postnatal instruction. Admission rates with bilirubin levels below treatment guidelines (12 mg/dL) were higher following instruction (30.7%) than with no instruction (14.4%). Limiting subjects to those meeting admission criteria increased ABE rates in all groups without altering conclusions. Conclusion Interactive antenatal instruction with postnatal reinforcement resulted in timely care seeking and a lower incidence of ABE. Impact Empowering mothers to participate in neonatal jaundice management is critical in low-income countries where jaundice monitoring and follow up are unreliable. Instructing mothers about jaundice in antenatal clinics with postnatal reinforcement is more effective than standard postpartum instruction in facilitating jaundice detection, timely care seeking, and lowering the incidence of acute bilirubin encephalopathy (ABE). Antenatal training also mitigates risks for ABE associated with out-of-hospital deliveries, limited antenatal care, and unskilled birth attendants. Impact: Adding structured jaundice instruction in antenatal clinics could greatly reduce bilirubin induced brain injury in countries where ABE is common.

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

Jiménez-Díaz,

Aune,

Elizarrarás-Rivas

et al. 2024

BMC Health Serv Res

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Background Neonatal jaundice is a common condition that can lead to brain damage and disabilities when severe cases go undetected. Low- and middle-income countries often lack accurate methods for detecting neonatal jaundice and rely on visual assessment, resulting in a higher incidence of adverse consequences. Picterus Jaundice Pro (Picterus JP), an easy-to-use and affordable smartphone-based screening device for the condition, has demonstrated higher accuracy than visual assessment in Norwegian, Philippine and Mexican newborns. This study aimed to identify the barriers and facilitators to implementing Picterus JP in public health services in low-income settings in Mexico by exploring the current process of neonatal jaundice detection and stakeholders’ perspectives in that context. Methods Qualitative data collection techniques, including one focus group, 15 semi-structured interviews and four observations, were employed in urban and rural health facilities in Oaxaca, Mexico. The participants included medical doctors, nurses and health administrators. The data were analysed by thematic analysis guided by the Consolidated Framework for Implementation Research. Results The analysis yielded four main themes: (I) the current state of neonatal care and NNJ detection, (II) the needs and desires for enhancing NNJ detection, (III) the barriers and facilitators to implementing Picterus JP in the health system and (IV) HCWs’ expectations of Picterus JP. The findings identify deficiencies in the current neonatal jaundice detection process and the participants’ desire for a more accurate method. Picterus JP was perceived as easy to use, useful and compatible with the work routine, but barriers to adoption were identified, including internet deficiencies and costs. Conclusions The introduction of Picterus JP as a supporting tool to screen for neonatal jaundice is promising but contextual barriers in the setting must be addressed for successful implementation. There is also an opportunity to optimise visual assessment to improve detection of neonatal jaundice.

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Neonatal Jaundice: Knowledge and Practices of Healthcare Providers and Trainees in Southwest Nigeria

Cited by 4 publications

References 52 publications

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

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

Antenatal jaundice instruction and acute bilirubin encephalopathy in Nigeria

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

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