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Infants with severe neonatal jaundice in Lagos, Nigeria: incidence, correlates and hearing screening outcomes
B O Olusanya1, A A Akande, A Emokpae
1Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. boolusanya@aol.com
Insights
Severe neonatal jaundice affects infants in Nigeria, with factors like maternal characteristics and birth practices contributing. Early detection and intervention are crucial to prevent hearing loss and reduce disease burden.
Area of Science:
- Neonatal care
- Public health
- Pediatrics
Background:
- Severe neonatal jaundice is a significant health concern in Nigeria.
- Understanding its incidence and risk factors is vital for effective public health strategies.
Purpose of the Study:
- To determine the incidence and associated factors of severe neonatal jaundice in Nigerian infants.
- To evaluate hearing screening outcomes in infants with severe neonatal jaundice.
Main Methods:
- A community-based study involving universal hearing screening for infants attending immunization clinics in Lagos.
- Multivariable logistic regression was used to identify correlates of severe neonatal jaundice.
Main Results:
- 6.7% of infants had a history of neonatal jaundice, with 5.5% receiving phototherapy and 1.9% exchange blood transfusion.
- Maternal religion, occupation, prenatal herbal use, infant gender, birth weight, multiple gestation, and place of birth were associated with severe jaundice.
- Significant proportions of infants with severe jaundice failed hearing tests, indicating a risk of sensorineural hearing loss.
Conclusions:
- Severe neonatal jaundice is linked to modifiable risk factors in the Nigerian population.
- Urgent policy interventions focusing on prevention, early detection, and timely treatment are necessary to mitigate the impact of severe neonatal jaundice.
Objectives:
To establish the incidence, correlates and hearing screening outcomes of infants with severe neonatal jaundice in Nigeria.
Methods:
Community-based study in which all infants attending Bacille Calmette-Guérin immunisation clinics in inner-city Lagos were enrolled into a universal hearing screening programme during which correlates of severe neonatal jaundice (requiring phototherapy and/or exchange blood transfusion) were explored with multivariable logistic regression.
Results:
Of the 5262 infants enrolled, only 48.7% were born in hospitals although almost all mothers (97.9%) attended antenatal clinics. 6.7% had a history of neonatal jaundice of whom 5.5% (95% CI:4.9-6.2) received phototherapy and 1.9% (95% CI:1.5-2.3) had an exchange blood transfusion. Factors independently associated with severe neonatal jaundice were maternal religion, occupation, use of herbal preparations during pregnancy, infant's gender, weight at screening, multiple gestation and place of birth. All but two infants with severe neonatal jaundice were exclusively breast-fed. Of those who failed the hearing tests, 17.3% were treated with phototherapy and 11.3% had an exchange blood transfusion. At least 8.9% of infants requiring phototherapy and 17.3% of those requiring exchange blood transfusion were at risk of sensorineural hearing loss.
Conclusions:
Severe neonatal jaundice is a significant condition associated with modifiable risk factors in this population. Policy initiatives for prevention, early detection followed by appropriate and timely intervention are urgently needed to reduce the disease burden.
Related Concept Videos
01:25Jaundice
01:31Hearing