Patterns of acute bilirubin encephalopathy in Nigeria: a multicenter pre-intervention study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-03-28

AUTHORS

Udochukwu M Diala, Richard P Wennberg, Isa Abdulkadir, Zubaida L Farouk, Carlos D. Coda Zabetta, Efe Omoyibo, Abieyuwa Emokpae, Aleksandr Aravkin, Bose Toma, Stephen Oguche, Tina Slusher, *On behalf of the Stop Kernicterus In Nigeria (SKIN) study group

ABSTRACT

BackgroundAcute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5–14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care.ObjectiveTo provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome.Study designThe incidence of ABE among newborns treated for hyperbilirubinemia was documented prospectively. Bivariate analysis and multivariate logistic regression were used to evaluate risk factors for acute bilirubin encephalopathy and reasons for regional differences in its occurrence.ResultsOf 1040 infants, 159 treated for hyperbilirubinemia (15.3%) had mild to severe bilirubin encephalopathy (including 35 deaths), but the incidence ranged from 7 to 22% between centers. Logistic regression identified four common predictors: total serum bilirubin (odds ratio 1.007 per mg/dl rise), out-of-hospital births (OR 2.6), non-alloimmune hemolytic anemia (OR 2.8), and delayed care seeking (OR 4.3).ConclusionThe high occurrence of bilirubin encephalopathy in Nigeria is due in large part to a delay in seeking care. A planned intervention strategy will target conditions leading to severe hyperbilirubinemia and delay. More... »

PAGES

873-880

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41372-018-0094-y

DOI

http://dx.doi.org/10.1038/s41372-018-0094-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1101832058

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29593357


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36 schema:description BackgroundAcute bilirubin encephalopathy (ABE) is an important cause of neonatal morbidity in Nigeria, accounting for 5–14% of neonatal deaths. Most newborns with severe ABE have irreversible damage before receiving treatment emphasizing the need for timely pre-admission monitoring and referral. There is limited evidence that educational interventions targeting mothers and health care providers will reduce delayed care.ObjectiveTo provide baseline data on the incidence of ABE and associated pre-admission risk factors in five centers of Nigeria in order to evaluate the effect of subsequent educational interventions on outcome.Study designThe incidence of ABE among newborns treated for hyperbilirubinemia was documented prospectively. Bivariate analysis and multivariate logistic regression were used to evaluate risk factors for acute bilirubin encephalopathy and reasons for regional differences in its occurrence.ResultsOf 1040 infants, 159 treated for hyperbilirubinemia (15.3%) had mild to severe bilirubin encephalopathy (including 35 deaths), but the incidence ranged from 7 to 22% between centers. Logistic regression identified four common predictors: total serum bilirubin (odds ratio 1.007 per mg/dl rise), out-of-hospital births (OR 2.6), non-alloimmune hemolytic anemia (OR 2.8), and delayed care seeking (OR 4.3).ConclusionThe high occurrence of bilirubin encephalopathy in Nigeria is due in large part to a delay in seeking care. A planned intervention strategy will target conditions leading to severe hyperbilirubinemia and delay.
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44 Nigeria
45 ObjectiveTo
46 acute bilirubin
47 acute bilirubin encephalopathy
48 analysis
49 anemia
50 baseline data
51 bilirubin
52 bilirubin encephalopathy
53 birth
54 bivariate analysis
55 care
56 care providers
57 care seeking
58 cause
59 center
60 common predictors
61 conditions
62 damage
63 data
64 death
65 delay
66 differences
67 educational intervention
68 effect
69 encephalopathy
70 evidence
71 factors
72 health care providers
73 hemolytic anemia
74 higher occurrence
75 hospital births
76 hyperbilirubinemia
77 important cause
78 incidence
79 infants
80 intervention
81 intervention strategies
82 irreversible damage
83 large part
84 limited evidence
85 logistic regression
86 monitoring
87 morbidity
88 most newborns
89 mothers
90 multivariate logistic regression
91 need
92 neonatal death
93 neonatal morbidity
94 newborns
95 occurrence
96 order
97 outcomes
98 part
99 patterns
100 pre-admission risk factors
101 pre-intervention study
102 predictors
103 providers
104 reasons
105 referral
106 regional differences
107 regression
108 risk factors
109 seeking
110 serum bilirubin
111 severe hyperbilirubinemia
112 strategies
113 study
114 subsequent educational interventions
115 total serum bilirubin
116 treatment
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