Affiliations: Department of Pediatrics and Child Health, College of
Health Sciences, Ladoke Akintola University of Technology, Osogbo, Nigeria
Note: [] Correspondence: Dr. Olusegun J. Adebami, Department of
Pediatrics, Ladoke Akintola University of Technology Teaching Hospital, Osogbo,
Nigeria. Tel.: +234 8037115347; E-mail: adebamisegun@yahoo.com; adebamiolusegun@gmail.com
Abstract: Acute bilirubin encephalopathy (ABE) is still a major and common
health problem in developing countries in spite of the availability and
efficacy of phototherapy and exchange blood transfusion. In developing
countries, the prevalence of kernicterus has not shown any reduction because
many babies with jaundice present very late in well established kernicterus.
The study was done to determine the factors responsible for the late
presentation of neonatal jaundice and development of ABE among the patients
presenting with this condition in our health facility. All newborns presenting
with ABE at the special care baby unit of the Ladoke Akintola University of
Technology Teaching Hospital, Osogbo, Nigeria were prospectively studied. The
diagnosis of ABE was made clinically if there were neurologic abnormalities
associated with hyperbilirubinemia. Twenty-eight (3.2%) of 882 babies
admitted over 3 yr had ABE. There were 21 males, 7 females, and the male:
female ratio 3:1. Twenty-two (78.6%) of the mothers saw at least one health
worker more than 24 hr before presentation. Three (10.4%) other mothers who
noticed the jaundice did not initiate any treatment while the remaining three
(10.4%) mothers did not notice the jaundice in their babies until they
presented at the health facility with the complaint of failure to suck.
Prescribed medications before presentation were oral antibiotics, hematinics
and gentamicin injections, a solution of Naphthalene balls in water and an
extract of local herbs made from Pawpaw leaves. Causes of jaundice were
septicemia, G6PD deficiency, ABO incompatibility, low birth weight and rhesus
isoimmunization in decreasing order of frequency. Maternal factors include low
socioeconomic status, teenage and low parity statuses of the mothers.
Inappropriate treatment of neonatal jaundice by health workers was also one of
the underlying reasons. Therefore, there is need to raise the level of
awareness in the community of the occurrence and dangers of neonatal jaundice
and its appropriate treatment. Health workers themselves need education and
training in the early recognition and treatment of neonatal jaundice.
