Transcutaneous Bilirubin Measurements and Serum Total Bilirubin Levels in Indigenous African Infants

Abstract

From these results, we can conclude that TcB measurements are a useful and reliable index for estimating STB levels in pigmented neonates, including those with hyperbilirubinemia and kernicterus. In the absence of reliable STB measurements, the relatively simple and noninvasive TcB measurements can be an important adjunct in directing phototherapy and exchange transfusions, thereby preventing bilirubin-induced morbidity and mortality in low-technology clinical environments.

Differences Between Transcutaneous and Serum Bilirubin Measurements in Black African Neonates

“…Skin color was classified as previously reported in this population, 14 and recorded by the trained nurse assistants as shown in a color guide (Supplemental Fig 5). G6PD evaluation was based on the fluorescent blood spot for all infants by using methods described by Beutler et al, 17 as previously reported.…”

“…9, 10, 14, 15, 21 -23 The TSB overestimation is also corroborated by several studies among multiracial populations 10,13,24 and black neonates. 14,15 For example, although Maisels et al 10 found a close correlation between TcB and TSB values among 849 neonates across all ethnic groups, by using JM-103, TSB was overestimated by ≥2 mg/ dL in 37.9% of blacks, compared with 1.8% of whites or 5.4% of other races. Among black infants, TSB was overestimated by ≥3 mg/dL in 17.4% and by ≥4 mg/dL in 6.7%.…”

“…This is in accordance with an earlier study that demonstrated strong correlations between TcB and TSB regardless of the degree of skin pigmentation. 14 …”

“…12 Limited evidence exists on the pattern and predictors of individual TcB-TSB divergence, especially in settings with predominantly dark-skinned infants or limited access to timely and reliable TSB measurements. [13][14][15] This study, therefore, set out to determine the prevalence and correlates of significant TcB overestimation in a black African population to facilitate optimal decisions for appropriate clinical intervention.…”

Survey and Management Outcome of Neonatal Jaundice from a Developing Tertiary Health Centre, Southern Nigeria.

“…Extreme hyperbilirubinaemia is uncommon in developed countries. It is still a common cause of neonatal morbidity and mortality in developing countries often resulting in kernicterus with its resultant burden, such as medical, economic and social, on the patient family and society at large 3 .…”