TITLE:
Acute Bilirubin Encephalopathy: A Propos of 151 Cases Collected during a Multicentric Study in Senegal
AUTHORS:
Serigne Tawa Ndiaye, Yaye Joor K. B. Dieng, Papa Moctar Faye, Mohameth Mbodj, Sofietou Dieye, Khadim Bop, Papa Souley Sow, Amadou Sow, Ndeye Fatou Sow, Ibrahima Diop, Aziz Faye, Sadio Konate, Ibrahima Diagne, Mousatapha Ndiaye, Ousmane Ndiaye
KEYWORDS:
Icterus, Encephalopathy, Phototherapy, Lethality
JOURNAL NAME:
Open Journal of Pediatrics,
Vol.13 No.1,
January
10,
2023
ABSTRACT: Introduction: Bilirubin encephalopathy is a debilitating complication of severe
neonatal unconjugated bilirubin jaundice. The aim of this study was to
determine the frequency of occurrence of this complication and to describe the
diagnostic and prognostic aspects in Senegal. Materials and Methods: This
was a multicenter, descriptive and analytical study conducted in 32 neonatal
units of various levels, with retrospective (January to December 2020) and
prospective (January to August 2021) collection. All neonates hospitalized for
acute bilirubin encephalopathy were included. The diagnostic criteria were the
presence of jaundice associated with neurological signs (muscle tone disorders,
abnormal movements, convulsions, etc.), with no other obvious etiology found.
The data were entered and analyzed using SPSS version 23 software. The
significance threshold was retained for a p-value Results: We
registered 151 patients. The mean age was 6 days and the sex ratio was 2.5
(clear male predominance). The majority of newborns were from Dakar (51%).
Twenty-two (22%) were premature and 32% had low birth weight. Half of the
newborns (50%) came from home and 87% were exclusively breastfed. The average
time to consult was 3 days. Neurological signs were dominated by decreased
primitive reflexes (74%), abnormal movements (59%) and lethargy (50%).
Dehydration (30%) and anemia (26%) were often associated. The mean bilirubin
level was 416 umol/l. Neonatal infections (19%) and Rhesus (16.7%) and ABO
(8.7) incompatibility were the main causes. One third (33%) of patients had
received intensive phototherapy and only 2% had received exchange blood
transfusion. The case fatality was 48.9%. Conclusion: Bilirubin
encephalopathy remains a major concern in Senegal. It is associated with high
mortality and numerous neurological sequelae. Progress in terms of early
detection and appropriate management is urgently needed on a national scale.