Aynalem Yared Asmare, Mulu Getaneh Baye, Akalu Tadesse Yirga, Shiferaw Wondimeneh Shibabaw
College of Health Science, Debre Birhan University, Debre Birhan, Ethiopia.
College of Health Science, Debre Markos University, Debre Markos, Ethiopia.
BMJ Paediatr Open. 2020 Sep 24;4(1):e000750. doi: 10.1136/bmjpo-2020-000750. eCollection 2020.
Hyperbilirubinaemia is a silent cause of newborn disease and death worldwide. However, studies of the disease in sub-Saharan Africa are highly variable with respect to its prevalence. Hence, this study aimed to estimate the overall magnitude of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase (G6PD) deficiency and blood-type incompatibility in sub-Saharan Africa.
PubMed, Scopus, Google Scholar and the Cochrane Review were systematically searched online to retrieve hyperbilirubinaemia-related articles. All observational studies reported the prevalence of hyperbilirubinaemia in sub-Saharan Africa were included for analysis and excluded if the study failed to determine the desired outcome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Heterogeneity across the included studies was evaluated using the inconsistency index (I). Subgroup and meta- regression analysis were also done. Publication bias was examined by funnel plot and the Egger's regression test. The random-effect model was fitted to estimate the pooled prevalence of neonatal hyperbilirubinaemia. The meta-analysis was performed using the STATA V.14 software.
A total of 30 486 studies were collected from the different databases and 10 articles were included for the final analysis. The overall magnitude of neonatal hyperbilirubinaemia was 28.08% (95% CI20.23 to 35.94, I=83.2) in sub-Saharan Africa. Neonates with G6PD deficiency (OR 2.42, 95% CI 1.64 to 3.56, I=37%) and neonates that had a blood type that was incompatible with their mother's (OR 3.3, (95% CI 1.96 to 5.72, I=84%) were more likely to develop hyperbilirubinaemia.
The failure to prevent and screen G6PD deficiency and blood-type incompatibility with their mother's results in high burden of neonatal hyperbilirubinaemia in sub-Saharan Africa. Therefore, early identification and care strategies should be developed to the affected neonates with G6PD deficiency and blood-type incompatibility with their mother's to address long-term medical and scholastic damages among those exposed to hyperbilirubinaemia.
高胆红素血症是全球新生儿疾病和死亡的一个隐匿原因。然而，撒哈拉以南非洲地区关于该疾病的研究在患病率方面差异很大。因此，本研究旨在估计撒哈拉以南非洲地区新生儿高胆红素血症的总体规模及其与葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症和血型不相容性的关联。
通过在线系统检索PubMed、Scopus、谷歌学术和考科蓝系统评价数据库，以获取与高胆红素血症相关的文章。纳入所有报告撒哈拉以南非洲地区高胆红素血症患病率的观察性研究进行分析，若研究未能确定预期结果则予以排除。遵循系统评价和Meta分析的首选报告项目指南。使用不一致指数（I）评估纳入研究之间的异质性。还进行了亚组分析和Meta回归分析。通过漏斗图和Egger回归检验检查发表偏倚。采用随机效应模型估计新生儿高胆红素血症的合并患病率。使用STATA V.14软件进行Meta分析。
从不同数据库共收集到30486项研究，最终纳入10篇文章进行分析。撒哈拉以南非洲地区新生儿高胆红素血症的总体规模为28.08%（95%CI 20.23至35.94，I = 83.2）。G6PD缺乏的新生儿（比值比2.42，95%CI 1.64至3.56，I = 37%）以及血型与其母亲不相容的新生儿（比值比3.3，95%CI 1.96至5.72，I = 84%）更易发生高胆红素血症。
未能预防和筛查G6PD缺乏症以及血型与其母亲不相容的情况，导致撒哈拉以南非洲地区新生儿高胆红素血症负担沉重。因此，应制定早期识别和护理策略，以应对患有G6PD缺乏症以及血型与其母亲不相容的受影响新生儿，解决那些暴露于高胆红素血症的儿童长期的医疗和学业损害问题。
