THE CHARACTERISTICS OF PROLONGED NEONATAL JAUNDICE INVESTIGATED AT PRIMARY HEALTH CLINICS IN KOTA BHARU, KELANTAN

Authors

  • Dr Hazlienor Mohd Hatta Kota Bharu District Health Office
  • Dr Mohd Ikhwan Azmi Kota Bharu District Health Office
  • Dr Nik Aida Nik Adib Kota Bharu District Health Office
  • Dr Najihah Mahfuzah Zakria Kota Bharu District Health Office
  • Dr Latifah Dahalan Kota Bharu District Health Office

DOI:

https://doi.org/10.37557/gjphm.v4i1.148

Keywords:

hyperbilirubinemia, neonatal jaundice, prolonged jaundice

Abstract

Introduction: Prolonged neonatal jaundice is affecting 15-40% of breastfed new-borns. Although breastmilk jaundice is the common aetiology, undetected pathological causes could lead to unfavourable sequelae. This study described the characteristics, aetiology and burden of prolonged neonatal jaundice investigated at the primary care level in Kota Bharu district. Methods: This crosssectional study was done from July till December 2019, involving 14 health clinics in Kota Bharu. Selection criteria involved term new-borns at day 14 of life or preterm at day 21 of life that had visible jaundice or serum bilirubin >85?mol/l. Clinical details, investigations, and management were carried out based on normal practice at the clinics. A registry was established to capture the burden. Results: Prolonged jaundice were detected among 22.5% [95% CI 21.5, 23.6] of new-borns attending primary health clinics in Kota Bharu. A total of 291 cases were further analysed; 275 (94.5%) were term newborns and 243 (83.5%) were breastfed. Affected new-borns underwent blood and urine sampling with multiple follow-ups. On average, jaundice subsided within 12 days [SD=5.5, 95% CI:11.7, 13.1] after detection of this condition. Majority had prolonged unconjugated hyperbilirubinemia (98.6%) and main aetiology was breastmilk jaundice (84.5%). Minority had hypothyroidism (3.4%) and conjugated hyperbilirubinemia (1.7%). Out of 129 cases sent for urine culture, 12 (9.3%) had significant growth, mostly E.coli. Conclusion: The majority of neonates with prolonged jaundice were term and breastfed. While the main aetiology was breastmilk jaundice, other underlying pathologies were also identified. As the burden of this condition is high, multistage investigation is strongly recommended. Urinary tract infections screening should be routinely considered.

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Author Biographies

Dr Hazlienor Mohd Hatta, Kota Bharu District Health Office

MBBS; Kota Bharu District Health Office, Kelantan, Malaysia

Dr Mohd Ikhwan Azmi, Kota Bharu District Health Office

MBBS; Kota Bharu District Health Office, Kelantan, Malaysia

Dr Nik Aida Nik Adib, Kota Bharu District Health Office

DrPH, Kota Bharu District Health Office, Kelantan, Malaysia

Dr Najihah Mahfuzah Zakria, Kota Bharu District Health Office

DrPH, Kota Bharu District Health Office, Kelantan, Malaysia

Dr Latifah Dahalan, Kota Bharu District Health Office

MPH, Kota Bharu District Health Office, Kelantan, Malaysia

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Published

2022-03-01

How to Cite

MOHD HATTA, H., Azmi, M. I., Nik Adib, N. A., Zakria, N. M., & Dahalan, L. (2022). THE CHARACTERISTICS OF PROLONGED NEONATAL JAUNDICE INVESTIGATED AT PRIMARY HEALTH CLINICS IN KOTA BHARU, KELANTAN. Global Journal of Public Health Medicine, 4(1), 558–569. https://doi.org/10.37557/gjphm.v4i1.148

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Original Articles