News & Learning

Recent Thrive Research on Newborn Jaundice

Since 2003, Thrive Networks has been a leader in reducing the impact of newborn jaundice in parts of Southeast Asia. Worldwide, 60 percent of newborns suffer from jaundice, but babies born in low-resource countries are most likely to suffer serious consequences from the disease. Through our efforts to provide phototherapy equipment, and our training of clinicians and technicians on equipment use and on proper care for infants with jaundice, we have treated thousands of newborns and continue to help thousands more who benefit from the programs we have put in place.

As part of our efforts to understand how best to treat jaundice in low-resource settings, we conduct careful and evidence-based research. Thrive’s research program is a critical component of our newborn health efforts, as we work to ensure not only that our equipment and interventions work but that they are appropriate for the low-resource countries they are designed to help. Our goal is to improve the health outcomes for newborns in these nations’ hospitals, which often have limited or outdated equipment or donated equipment that is not suitable for these settings, very low staff-to-patient ratios, and a limited capacity of clinical training – sometimes in fundamental activities such as handwashing and basic nursing care.

Below is our most recently published research on newborn jaundice and a peek at current efforts:

Study Findings

• In Myanmar, a two-year study of the jaundice program we put in place in four hospitals showed that our program was having a significant positive impact. Our program, which provided phototherapy equipment for newborns with jaundice, as well as training for clinicians and technicians on using the equipment, helped lead to a 69% and 33% reduction in blood transfusions needed for newborns with jaundice born within and outside of the hospitals, respectively. A reduction in blood transfusions reflects early and effective treatment of jaundice.*
• Also in Myanmar, we conducted a study in two pediatric hospitals to determine major risk factors for admission of infants with severe jaundice. After analyzing data on 590 newborns treated on new phototherapy machines over a 13-20 month period, researchers identified home births and G6PD, a common genetic deficiency, as major risk factors.**
• In collaboration with global experts on neonatal jaundice, including the University of Trieste, we published a review of newborn jaundice in low-resource countries. The paper provides a current analysis and suggestions for future pathways to improve neonatal jaundice in these locations. The recommendations include:
  • having a coordinated worldwide effort to define the burden and causes of severe neonatal jaundice and its consequences,
  • instituting an aggressive educational programs for families and clinicians to ensure timely care, and
  • ensuring that accurate diagnostics and effective phototherapy equipment are in place.***

In Progress: Bilirubin Testing Device

In Vietnam, we are testing an innovative device for detecting neonatal jaundice that has the potential to be particularly useful in low-resource settings. The device, called the “Bilistick,” is designed to identify the level of bilirubin – the substance in the blood that indicates a high level of jaundice, or hyperbilirubinemia – more quickly, less costly and less invasively than a traditional blood test. Clinicians collect blood samples from a heel prick and then insert the Bilistick test strip into a reader to determine the level of bilirubin in the blood. The device was developed by Bilimetrix.

If proven effective, the Bilistick could be a tremendous boon for low-resource hospitals, which often don’t have access to laboratories and/or have non-functioning bilirubin diagnostic equipment. Newborns are often falsely determined to be cured of jaundice, only to be sent home prematurely where severely disabling problems can occur.

Ten hospitals are participating in the study, which we are conducting in partnership with MTTS, a Vietnamese social enterprise; thus far more than 2000 individual entries have been collected. The study is expected to be completed by the end of 2016.

* https://www.ncbi.nlm.nih.gov/pubmed/26678312

** https://mhnpjournal.biomedcentral.com/articles/10.1186/s40748-015-0024-3

*** http://thrivenetworks.org/wp-content/uploads/2016/06/DOTYR-15-Neonatology-Paper.pdf