TITLE:
Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon
AUTHORS:
Anne Esther Njom Nlend, Dominique Kamtchoua Ndjenje, Arsène Brunelle Sandie
KEYWORDS:
Neonatal Jaundice, Transcutaneous Bilirubin Measurement, Total Serum Bilirubin, Screening in Full Term Infant
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.12 No.3,
July
28,
2022
ABSTRACT: Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains
critical in dark skinned babies of low resource settings. Objective: To
assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin
(Tsb) values in full term neonates with jaundice. Methodology: An
analytical cross-sectional study was conducted at the neonatology unit of the
Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates
aged 0 to 7 days with suspected jaundice who did not receive phototherapy were
eligible for the study. The enrolled neonates in the study were assessed
clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20
transcutaneous bilirubinometer highest measurement over the forehead and the
sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software.
Correlation was captured by Bland & Alman plots and Concordance Correlation
Coefficient (CCC) estimates. The Pearson correlation coefficient and Student
test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates.
The sex ratio of the babies included was 1.25 favouring males. Median
Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB
corresponding to the maximum average between frontal and sternal measurement
was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good
linear correlation was found between TcB and total serum bilirubin level r =
0.86 [0.80; 0.91]. Positive correlation was noted between both (forehead and
sternum) TcB measurements sites, namely r
= 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l
(confidence interval at 95%, 21.14 - 80.50). The
CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement
threshold and post-natal age. The ROC area under the curve value for a
threshold Conclusion: A good linear correlation was found despite a poor agreement
between TcB and Tsb. TcB method systematically overestimated the value of TsB.