Root causes for late presentation of severe neonatal hyperbilirubinaemia in Egypt

ABSTRACT

This study aimed to understand the reasons for late presentation of cases of severe neonatal hyperbilirubinaemia. We administered a questionnaire to parents of 130 infants with severe jaundice admitted to Cairo University Children's Hospital neonatal intensive care unit at age >/= 6 days over an 18-month period. Although 125 infants [96.2%] were delivered in a health care facility, no discharge physical examination was performed in 99/125 cases [79.2%]. No parent was given instructions about neonatal jaundice and no follow-up appointments were scheduled. Parents of 109 infants sought medical advice prior to hospital readmission; most babies were assessed clinically, but serum bilirubin was measured in only one-quarter of cases [28/109]. Medical advice included placing the infant under a neon lamp at home [87/109 cases], advice to supplement breastfeeding [75/109] and prescribed medications, including vitamins [15/109]. Increasing the availability of inexpensive point-of-care diagnostic instruments and phototherapy units in health care facilities are urgently needed