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