Nsambya Hospital, Kampala, Uganda, Paediatrics and Child Health.
Mulago hospital, Paediatrics and Child Health; College Of HealthSciences Makerere University, Paediatrics & Child Health.
Afr Health Sci. 2020 Mar;20(1):397-405. doi: 10.4314/ahs.v20i1.46.
With targeted management of neonatal hyperbilirubinaemia in high-income countries, there has been a drastic drop in both the prevalence and mortality. On the contrary, over two-thirds of the global burden of neonatal hyperbilirubinaemia is in Sub-saharan Africa and South East Asia with a high mortality risk of 16-35%. Neonatal hyperbilirubinaemia is not a leading global cause of neonatal mortality, however leads to irreversible neurological damage and death when managed poorly. Three-quarters of the babies admitted to the national referral hospital in Uganda had significant hyperbilirubinaremia; 16.6% of these babies died. We aimed at determining the prevalence, treatment outcome and describing factors associated with hyperbilirubinaemia in neonates admitted to St Francis hospital, Nsambya.
A cross sectional study was carried out. A total of 242 files of babies with a preliminary diagnosis of hyperbilirubinaemia were retrieved retrospectively. Relevant data was extracted from the files and analysed using STATA version 14.0.
The prevalence of significant hyperbillirubinaemia was 22.7% (55/242). Seventy-seven percent of the babies admitted did not require treatment for hyperbilirubinaemia. No factors were found to be significantly associated with significant hyperbilirubinaemia. The case fatality for severe hyperbilirubinaemia was 20% (6/30); half of these babies had haemolytic disease of the newborn.
Establishment of local guidelines will prevent unnecessary admissions and ensure timely treatment is administered. Longitudinal studies are required to discover factors associated with neonatal hyperbilirubinaemia in this region.
在高收入国家,通过对新生儿高胆红素血症的靶向管理,其患病率和死亡率都大幅下降。相比之下,超过三分之二的新生儿高胆红素血症负担在撒哈拉以南非洲和东南亚,其死亡率风险高达 16-35%。新生儿高胆红素血症不是导致全球新生儿死亡的主要原因,但如果管理不善,会导致不可逆转的神经损伤和死亡。乌干达国家转诊医院收治的四分之三的婴儿都有明显的高胆红素血症;其中 16.6%的婴儿死亡。我们旨在确定在 Nsambya 的圣弗朗西斯医院住院的新生儿高胆红素血症的患病率、治疗结果,并描述与之相关的因素。
进行了一项横断面研究。回顾性检索了 242 份初步诊断为高胆红素血症的婴儿病历。从病历中提取相关数据并使用 STATA 版本 14.0 进行分析。
显著高胆红素血症的患病率为 22.7%(55/242)。77%的入院婴儿不需要治疗高胆红素血症。未发现任何因素与显著高胆红素血症有显著关联。严重高胆红素血症的病死率为 20%(6/30);其中一半婴儿患有新生儿溶血病。
制定当地指南将可防止不必要的住院,并确保及时进行治疗。需要进行纵向研究以发现该地区新生儿高胆红素血症的相关因素。