Evaluation of the Bilicheck® transcutaneous bilirubinometer in jaundiced Nigerian term and preterm neonates

Background: Transcutaneous bilirubinometry has shown some promise as a safe, non-invasive method that correlates well with traditional laboratory methods of estimating serum bilirubin. However there is a paucity of studies done on neonates of African descent. Aim: The aim of the study was to evaluate the diagnostic performance of the Bilichek® transcutaneous bilirubinometer in jaundiced Nigerian term and preterm neonates. Methods: This was a cross-sectional study involving 169 jaundiced preterm and term neonates studied over a 4 month period. A total of 200 transcutaneous bilirubin (TcB) readings determined using the Bilichek® device were obtained simultaneously with total serum bilirubin (TSB) readings determined by the diazo method. Results: The mean (SD) difference between TcB and TSB was 1.5 (2.6) mg/dL (95% CI of 1.2 - 1.9 mg/dL); p= 0.000. There was strong correlation between T cB and TSB with a correlation coefficient (r) of 0.77 (p = 0.000). The 95% limits of agreement were between -3.5mg/dL and 6.6mg/dL. There was poor correlation between TcB and TSB of r= 0.43 at high TSB levels >12mg/dl. The TcB cut-off that most accurately predicted TSB was 11.7mg/dL. Conclusion: Transcutaneous bilirubinometry is a reliable screening method for assessing severity of hyperbilirubinaemia in black African neonates. However, due to the occurrence of wide disparities, confirmatory serum bilirubin measurements should be done for TcB values above 11.7mg/dL

Experience With Hydroxy Carbamide Use; Indications, Adverse Effects And Clinical Course At A Tertiary Care Hospital In Lagos

Introduction: Sickle cell disease is the most common inherited haemoglobin disorder with the highest prevalence in Sub-saharan Africa. The clinical course of the disease has improved with newborn screening, penicillin prophylaxis and hydroxycarbamide use amongst other interventions. Despite the data on the benefit of hydroxycarbamide use, the uptake of hydroxycarbamide in poor resource  settings is still very low. Materials and Methods: This was a retrospective study at the Lagos University Teaching Hospital from January to December 2017 among children with sickle cell anemia on hydroxycarbamide. Ethical Approval was obtained from the Health, Research and Ethicscommittee of the Hospital. Statistical analysis was with SPSS version 20. Results: Atotal of 1039 children were seen in the period under review with 13.5% of them on hydroxycarbamide. The commonest  indication for hydroxycarbamide was high risk for stroke while lumbar infarction was the least common indication. Adverse effects were seen in 2.1% of the recipients and all these patients had derangements of liver function. None of the recipients had hematologic adverse effects. Conclusion: The use of hydroxycarbamide is relatively safe among children living in resource constrained settings but long term follow-up among a larger cohort is desired. Key words: Hydroxycarbamide, indications, sickle cell diseas