Community health worker-led household screening and management of neonatal hyperbilirubinemia in rural Bangladesh: a cluster randomized control trial protocol

Gates Open Research

article

Eric M. Foote¹  Farjana Jahan²  Mahbubur Rahman²  Sarker Masud Parvez²  Tasnim Ahmed¹  Rezaul Hasan²  Farzana Yeasmin²  Shams El Arifeen⁴  Sk Masum Billah⁴  Mahbubul Hoque⁶  Mohammad L. Shahidullah⁷  Muhammad Shariful Islam⁸  Vinod K Bhutani¹  Gary Darmstadt¹ 

[1] Prematurity Research Center, Department of Pediatrics, Stanford University School of Medicine;Environmental Intervention Unit, International Centre for Diarrheal Disease Research;Children;Maternal and Child Health Division, International Centre for Diarrheal Disease Research;Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney;Department of Neonatology, Bangladesh Shishu Hospital & Institute Dhaka;Bangabandhu Sheikh Mujib Medical University;National Newborn Health Program ,(NNHP) and Integrated Management of Childhood Illness ,(IMCI), Directorate General of Health Services

关键词: neonatal hyperbilirubinemia;    community health workers;    low to middle income country;    global health;   

DOI  :  10.12688/gatesopenres.14033.1

学科分类：电子与电气工程

来源: American Journal Of Pharmtech Research

【 摘 要 】

Background: Extreme hyperbilirubinemia leading to neurologic disability and death is disproportionately high in low to middle income countries (LMIC) such as Bangladesh, and is largely preventable through timely treatment. Of the estimated 50% of newborns born in LMICs born at home, few receive screening or treatment for hyperbilirubinemia, leading to 6 million newborns per year who need phototherapy treatment for hyperbilirubinemia but are untreated. Household screening and treatment for neonatal hyperbilirubinemia with phototherapy administered by a trained community health worker (CHW) may increase indicated treatment for neonatal hyperbilirubinemia in comparison to the existing care system in Bangladesh. Methods: 530 Bangladeshi women in their 2nd or 3rd trimester of pregnancy from the rural community of Sakhipur, Bangladesh will be recruited for a cluster randomized trial and randomized to the intervention arm — home screening and treatment for neonatal hyperbilirubinemia — or the comparison arm to receive usual care. In the intervention arm, CHWs will provide mothers with two prenatal visits, visit newborns by 2 days of age and then daily for 3 days to measure transcutaneous bilirubin (TcB) and monitor clinical danger signs. Newborns without danger signs but with a TcB above the treatment threshold <15 mg/dL will be treated with light-emitting diode (LED) phototherapy at home. Newborns with danger signs or TcB 15 mg/dL will be referred to a hospital for treatment. Treatment rates for neonatal hyperbilirubinemia in each arm will be compared. Conclusion: This study will evaluate the effectiveness of CHW-led home phototherapy to increase neonatal hyperbilirubinemia treatment rates in rural Bangladesh. LMICs are expanding access to postnatal care by using CHWs, and our work will give CHWs a curative treatment option for neonatal hyperbilirubinemia. Similar projects in other LMICs can be pursued to dramatically extend healthcare access to vulnerable newborns with hyperbilirubinemia.

【 授权许可】

CC BY