AI Article Synopsis
- Extreme hyperbilirubinemia in newborns is a major issue in low- and middle-income countries like Bangladesh, leading to significant health risks, especially since many births occur at home without screening or treatment.
- A cluster randomized trial will involve 530 pregnant women in rural Bangladesh, where community health workers (CHWs) will screen and provide home treatment for newborns with jaundice, comparing results to traditional care methods.
- The study aims to determine if CHW-led home phototherapy can effectively increase treatment rates for neonatal hyperbilirubinemia, potentially allowing for similar programs in other low-income settings to improve newborn health outcomes.
Article Abstract
Background: Extreme hyperbilirubinemia leading to neurologic disability and death is disproportionately higher in low- and middle-income countries (LMIC) such as Bangladesh, and is largely preventable through timely treatment. In LMICs, an estimated half of all newborns are born at home and few receive screening or treatment for hyperbilirubinemia, leading to 6 million newborns per year who need phototherapy treatment for hyperbilirubinemia but are untreated. Household screening and treatment for neonatal hyperbilirubinemia with phototherapy administered by a trained community health worker (CHW) may increase indicated treatment for neonatal hyperbilirubinemia in comparison to the existing care system in Bangladesh.
Methods: 530 Bangladeshi women in their second or third trimester of pregnancy from the rural community of Sakhipur, Bangladesh will be recruited for a cluster randomized trial and randomized to the intervention arm - home screening and treatment for neonatal hyperbilirubinemia - or the comparison arm to receive usual care. In the intervention arm, CHWs will provide mothers with two prenatal visits, visit newborns by 2 days of age and then daily for 3 days to measure transcutaneous bilirubin (TcB) and monitor for clinical danger signs. Newborns without danger signs but with a TcB above the treatment threshold, but >15 mg/dL will be treated with light-emitting diode (LED) phototherapy at home. Newborns with danger signs or TcB ≥15 mg/dL will be referred to a hospital for treatment. Treatment rates for neonatal hyperbilirubinemia in each arm will be compared.
Conclusion: This study will evaluate the effectiveness of CHW-led home phototherapy to increase neonatal hyperbilirubinemia treatment rates in rural Bangladesh. LMICs are expanding access to postnatal care by using CHWs, and our work will give CHWs a curative treatment option for neonatal hyperbilirubinemia. Similar projects in other LMICs can be pursued to dramatically extend healthcare access to vulnerable newborns with hyperbilirubinemia.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249711 | PMC |
| http://dx.doi.org/10.12688/gatesopenres.14033.2 | DOI Listing |
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