Conflict of interest: The authors have no disclosures or conflicts of interest.
Home-use icterometry in neonatal hyperbilirubinaemia: Cluster-randomised controlled trial in Vietnam
Article first published online: 2 JUN 2014
© 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
Journal of Paediatrics and Child Health
Volume 50, Issue 9, pages 674–679, September 2014
How to Cite
Luu, M. N., Le, L. T., Tran, B. H., Duong, T. K., Nguyen, H. T., Le, V. T. and Partridge, J. C. (2014), Home-use icterometry in neonatal hyperbilirubinaemia: Cluster-randomised controlled trial in Vietnam. Journal of Paediatrics and Child Health, 50: 674–679. doi: 10.1111/jpc.12611
- Issue published online: 25 AUG 2014
- Article first published online: 2 JUN 2014
- Manuscript Accepted: 2 MAR 2014
- UCSF Medical Center Foundation
- UCSF Dean's Office
- UCSF Office of International Programs
- Vietnamese American Medical Association
- Tung Van Dinh MD Memorial Travel Scholarship
- community medicine;
- developing country;
- parent education;
To determine whether home-use icterometry improves parental recognition of neonatal jaundice, early care seeking and treatment to minimize risks of bilirubin encephalopathy.
Cluster-randomised controlled trial of community-level icterometry used at home by mothers in Chi Linh, Vietnam. 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.
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.
In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.