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Demystifying non-invasive approaches for screening jaundice in low resource settings: a review
Umme Abiha1,2, Dip Sankar Banerjee3, Saptarshi Mandal4
1Department of Smart Healthcare, Indian Institute of Technology, Jodhpur, India.
Insights
Neonatal screening for jaundice, a critical measure to prevent brain damage, urgently needs non-invasive tools. This review explores innovative methods to replace invasive blood tests, improving infant comfort and efficiency.
Area of Science:
- Neonatal Medicine
- Biomedical Engineering
- Public Health
Background:
- Pediatric guidelines mandate neonatal bilirubin screening to prevent acute bilirubin encephalopathy (ABE) and Kernicterus.
- Current gold standard involves invasive blood collection and biochemical testing, causing infant stress and delayed results.
- There is a significant need for non-invasive screening methods to improve efficiency and infant well-being.
Purpose of the Study:
- To review non-invasive approaches and digital solutions for neonatal bilirubin screening.
- To emphasize the application of these methods in low-resource settings.
- To identify challenges and future research directions in non-invasive neonatal jaundice screening.
Main Methods:
- Comprehensive literature review of non-invasive bilirubin measurement techniques.
- Focus on transcutaneous bilirubin meters and digital solutions.
- Analysis of methodologies, practical applications, and limitations.
Main Results:
- Non-invasive methods, particularly transcutaneous bilirubin meters, offer a promising alternative to invasive testing.
- Digital solutions are emerging for improved accessibility and efficiency in screening.
- Challenges remain in accuracy, standardization, and widespread implementation, especially in resource-limited areas.
Conclusions:
- Non-invasive screening is crucial for reducing infant discomfort and improving jaundice detection efficiency.
- Further research and development are needed for enhanced accuracy and clinical integration.
- Educational programs for families and healthcare providers are essential for timely jaundice management.
Abstract:
All national and international pediatric guidelines universally prescribe meticulous bilirubin screening for neonates as a critical measure to mitigate the incidence of acute bilirubin encephalopathy (ABE) and Kernicterus. The prevailing gold standard for jaundice detection in neonates necessitates invasive blood collection, followed by subsequent biochemical testing. While the invasive procedure provides dependable bilirubin measurements and continues to be the sole gold standard diagnostic method for assessing bilirubin concentration. There exists a pressing need to innovate non-invasive screening tools that alleviate the sampling stress endured by newborns, mitigate iatrogenic anemia, and expedite the turnaround time for obtaining results. The exploration of non-invasive modalities for bilirubin measurements is gaining momentum, driven by the overarching goal of minimizing the number of pricks inflicted upon neonates, thereby rendering screening a swift, efficient, comfortable, and dependable process. This comprehensive review article delves extensively into the array of non-invasive approaches and digital solutions that have been proposed, implemented, and utilized for neonatal bilirubin screening, with a particular emphasis on their application in low-resource settings. Within this context, the review sheds light on the existing methodologies and their practical applications, with a specific focus on transcutaneous bilirubin meters. Moreover, it underscores the prevailing open challenges in this domain and outlines potential directions for future research endeavors. Notably, the review underscores the imperative need for robust educational programs targeted at both families and healthcare personnel to expedite the process of seeking timely care for neonatal jaundice. Additionally, it underscores the necessity for the development of enhanced screening and diagnostic tools that can offer greater accuracy in clinical practice.
