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加纳儿童的新生儿黄疸:评估产妇的知识、态度和看法。

Neonatal jaundice in Ghanaian children: Assessing maternal knowledge, attitude, and perceptions.

机构信息

Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana.

Department of Child Health, Holy Family Hospital, Nkawkaw, Eastern Region, Ghana.

出版信息

PLoS One. 2022 Mar 3;17(3):e0264694. doi: 10.1371/journal.pone.0264694. eCollection 2022.

Abstract

BACKGROUND

Neonatal jaundice (NNJ) is a major cause of preventable childhood mortality and long-term impairment especially in countries with significant prevalence of the inherited condition, glucose-6-phosphate dehydrogenase (G6PD) defect. In Ghana, routine screening of pregnant women for G6PD defect is standard care. Prevention of poor health outcomes from NNJ is contingent on population health literacy and early diagnosis. As part of a project to evaluate a screening tool for NNJ, we assessed the knowledge, attitude, and perceptions of Ghanaian mothers on NNJ at baseline.

METHODS

Using a cross-sectional design, mothers attending antenatal and postnatal clinics at 3 selected health facilities in 2 geographical regions of Ghana were interviewed. Data on mothers' understanding, perceptions, beliefs, and actions towards NNJ were evaluated. Chi-square test was used to determine the association between selected maternal characteristics and knowledge, attitude, and perception to NNJ.

RESULTS

Of the 504 mothers interviewed, 428(85.4%) had heard about NNJ, 346 (68.7%) said the earliest signs are seen in the eyes, 384(76.2%) knew NNJ may be harmful and 467(92.7%) recommended seeking healthcare for the jaundiced newborn. None of the women knew about G6PD or their G6PD status following antenatal screening. Most did not know the signs/symptoms of severe NNJ. Of the 15 mothers who had had a jaundiced neonate, cost was the most perceived (8 out of 15) barrier to accessing health care. There were significant associations (p-value ≤ 0.05) between maternal age, educational level, and knowledge of NNJ.

CONCLUSION

Despite the high level of awareness of NNJ, gaps still exit in the knowledge, attitudes and perceptions of mothers concerning NNJ. Improving education of women about the causes, symptoms/signs, and the role of G6PD in severe NNJ is recommended. Addressing barriers to accessing healthcare for the jaundiced infant may enhance timely management of NNJ and reduce the associated complications and mortality.

摘要

背景

新生儿黄疸(NNJ)是可预防的儿童死亡和长期残疾的主要原因,尤其是在葡萄糖-6-磷酸脱氢酶(G6PD)缺陷等遗传性疾病发病率较高的国家。在加纳,对孕妇进行 G6PD 缺陷常规筛查是标准护理。预防 NNJ 不良健康后果取决于人口健康素养和早期诊断。作为评估 NNJ 筛查工具项目的一部分,我们在基线时评估了加纳母亲对 NNJ 的知识、态度和看法。

方法

采用横断面设计,在加纳 2 个地理区域的 3 家选定的卫生机构的产前和产后诊所采访了母亲。评估了母亲对 NNJ 的理解、看法、信念和行动。卡方检验用于确定选定的母亲特征与对 NNJ 的知识、态度和看法之间的关联。

结果

在接受采访的 504 位母亲中,有 428 位(85.4%)听说过 NNJ,有 346 位(68.7%)表示最早的迹象出现在眼睛,有 384 位(76.2%)知道 NNJ 可能有害,有 467 位(92.7%)建议为黄疸新生儿寻求医疗保健。没有一位女性了解 G6PD 或她们在产前筛查后的 G6PD 状态。大多数人不知道严重 NNJ 的体征/症状。在 15 位有黄疸新生儿的母亲中,有 8 位(15 位中的 8 位)认为费用是获得医疗保健的最大障碍。母亲年龄、教育水平和 NNJ 知识之间存在显著关联(p 值≤0.05)。

结论

尽管对 NNJ 的认识水平很高,但母亲对 NNJ 的知识、态度和看法仍存在差距。建议加强对妇女进行 NNJ 的原因、症状/体征以及 G6PD 在严重 NNJ 中的作用的教育。解决黄疸婴儿获得医疗保健的障碍可能会增强对 NNJ 的及时管理,减少相关并发症和死亡率。

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