A Global Need for Affordable Neonatal Jaundice Technologies

被引:93
作者
Slusher, Tina M. [1 ]
Zipursky, Alvin [2 ]
Bhutani, Vinod K. [3 ,4 ]
机构
[1] Univ Minnesota, Ctr Global Pediat, Minneapolis, MN 55414 USA
[2] Hosp Sick Children, Programme Global Paediat Res, Toronto, ON M5G 1X8, Canada
[3] Stanford Univ, Dept Pediat, Div Neonatal Dev Med, Sch Med, Stanford, CA 94305 USA
[4] Lucile Packard Childrens Hosp, Stanford, CA USA
关键词
affordable technologies; developing nations; hyperbilirubinemia; newborn jaundice; phototherapy; severe neonatal hyperbilirubinemia; GLUCOSE-6-PHOSPHATE-DEHYDROGENASE DEFICIENCY; NEAR-TERM; HYPERBILIRUBINEMIA; RISK; NEWBORN; KERNICTERUS; TRANSFUSION; PREDICTION; MORBIDITY;
D O I
10.1053/j.semperi.2011.02.014
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Globally, health care providers worldwide recognize that severe neonatal jaundice is a "silent" cause of significant neonatal morbidity and mortality. Untreated neonatal jaundice can lead to death in the neonatal period and to kernicterus, a major cause of neurologic disability (choreo-athetoid cerebral palsy, deafness, language difficulty) in children who survive this largely preventable neonatal tragedy. Appropriate technologies are urgently needed. These include tools to promote and enhance visual assessment of the degree of jaundice, such as simpler transcutaneous bilirubin measurements and readily available serum bilirubin measurements that could be incorporated into routine treatment and follow-up. Widespread screening for glucose-6-phoshate dehydrogenase deficiency is needed because this is often a major cause of neonatal jaundice and kernicterus worldwide. Recognition and treatment of Rh hemolytic disease, another known preventable cause of kernicterus, is critical. In addition, effective phototherapy is crucial if we are to make kernicterus a "never-event." Finally it is essential that we conduct appropriate population-based studies to accurately elucidate the magnitude of the problem. However, knowledge alone is not sufficient. If we are to implement these and other programs and technologies to relegate severe neonatal jaundice and its sequelae to the history books, screening and interventions must be low cost and technologically appropriate for low and middle income nations. © 2011 Elsevier Inc.
引用
收藏
页码:185 / 191
页数:7
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