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Home‐use icterometry in neonatal hyperbilirubinaemia: C luster‐randomised controlled trial in V ietnam
Author(s) -
Luu Mitchell N,
Le Loc T,
Tran Bich H,
Duong Tuan K,
Nguyen Ha T,
Le Vui T,
Partridge John C
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12611
Subject(s) - medicine , jaundice , pediatrics , cluster randomised controlled trial , randomized controlled trial
Aim To determine whether home‐use icterometry improves parental recognition of neonatal jaundice, early care seeking and treatment to minimize risks of bilirubin encephalopathy. Methods Cluster‐randomised controlled trial of community‐level icterometry used at home by mothers in C hi L inh, V ietnam. Rural health‐care workers identified and enrolled term newborns. Post‐partum mothers received jaundice education and icterometry instructions and were cluster‐randomised by commune. Cases received icterometers (icterometer group ( IG )) and controls did not (control group ( CG )). Subjects received mobile telephone calls from post‐natal days 2–7 to determine maternal recognition by visual inspection and icterometer detection of jaundice (≥3.0 on five‐point scale). Mothers without telephones, premature newborns (<35 weeks) or newborns hospitalised >5 days were excluded. Results Three hundred fifty‐two subjects were enrolled (183 IG and 169 CG ), of whom 11 (3.4%) were lost to telephone follow‐up. Jaundice was recognised and/or detected in 94 (27%) of all newborns. Icterometry helped 11 mothers (6%) detect neonatal jaundice that was not visually recognised by IG mothers. Detection by IG mothers was not statistically greater than CG mothers ( P = 0.09). Follow‐up care seeking was 8% in both groups ( P = 0.2), and 11% of jaundiced newborns received treatment (9% IG vs. 16% CG , P = 0.3). Newborns who received care had bilirubin measurements that averaged 257 μmol/L IG vs. 322 μmol/L CG ( P = 0.3). There were no deaths. Conclusions In this pilot study, home‐use icterometry may help improve parental detection of jaundice in rural V ietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.