Survey and Management Outcome of Neonatal Jaundice from a Developing Tertiary Health Centre, Southern Nigeria.

Abstract

Background information: Neonatal jaundice is a very common condition worldwide, occurring in up to 60% of term and 80% of preterm new born in the first week of life. The incidence, aetiological and contributory factors to neonatal jaundice differs in ethnicity and geographical distribution. In Nigeria, it accounts for between 23% and 60% of admission into the Special Care Baby Unit (SCBU), and various factors are responsible for its occurrence. The aim of the study was to assess the frequency , determinants, prevalence and predictors of Neonatal jaundice among in-born neonates and out-born neonates managed in Niger Delta University Teaching Hospital(NDUTH), Okolobiri, Bayelsa State Material and Method: A retrospective descriptive study of Case file of all in-born and out-born neonates admitted in Special Care for neonatal jaundice from January 2010 to December, 2012 were included. Information from case file of the index cases were collected using a proforma of data collection sheet within a ten week period. Socio-demographic characteristics, associated risk factors, prevalence rate for each year, survival rate, treatment modalities and out-come were determined. The data was organized, validated, and analysed using SPSS. Quantitative variables were summarized using range, mean, and standard deviation. Categorical variables were tabulated using frequencies and percentages. Chi-square test were used for testing the significance of association between categorical variables. Student’s ttest was used to compare two means. Survival rate of treatment modalities determined. Result: A total of 664 neonates were admitted into the special care baby unit of the Pediatrics department, NDUTH. 199 (17.9%) of the neonates were diagnosed with neonatal jaundice(NNJ). Majority of which were aged between 1-2 days making about 82 (41.2%) of the neonates with NNJ.The males, were most commonly affected 121 (60.8%) compared to females 78 (39.2%). Maternal age with the highest cases of children with NNJ was between 26-30 years, 59 (29.6%). Majority of the women had secondary level of education, 121 (60.8%).The prevalence rate were 240, 227), 300 per 1000 neonates admitted in the hospital for 2010.2011 and 2012 respectively. The identifiable risk factors in this study were preterm’s 81(40.7%), low birth weights 105(52.8%), poor maternal booking status, neonatal sepsis 119(59.8%) and birth asphyxia (low APGAR score).The use of more than one treatment modality improve survival rate of neonates with Jaundice. Phototherapy is the most important option that must be used in the management of Neonatal Jaundice. Conclusion: Neonatal jaundice remains high among cases admitted into the special care baby unit in developing nations. Therefore antenatal and neonatal care should be improved and supported by all health care stakeholders if childhood millennium development goals would be achieved. .