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Prevalence, factors associated and treatment outcome of hyperbilirubinaemia in neonates admitted to St Francis hospital, Nsambya, Uganda: a descriptive study
Abstract
Background: With targeted management of neonatal hyperbilirubinaemia in high-income countries, there has been a dras- tic drop in both the prevalence and mortality. On the contrary, over two-thirds of the global burden of neonatal hyperbiliru- binaemia 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 hyperbilirubin- aremia; 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.
Methods: A cross sectional study was carried out. A total of 242 files of babies with a preliminary diagnosis of hyperbiliru- binaemia were retrieved retrospectively. Relevant data was extracted from the files and analysed using STATA version 14.0.
Results: The prevalence of significant hyperbillirubinaemia was 22.7% (55/242). Seventy-seven percent of the babies ad- mitted did not require treatment for hyperbilirubinaemia. No factors were found to be significantly associated with sig- nificant hyperbilirubinaemia. The case fatality for severe hyperbilirubinaemia was 20% (6/30); half of these babies had haemolytic disease of the newborn.
Conclusion: Establishment of local guidelines will prevent unnecessary admissions and ensure timely treatment is admin- istered. Longitudinal studies are required to discover factors associated with neonatal hyperbilirubinaemia in this region.
Keywords: Neonatal jaundice; hyperbilirubinaemia; phototherapy; exchange transfusion.