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. 2020 Sep 24;4(1):e000750.
doi: 10.1136/bmjpo-2020-000750. eCollection 2020.

Prevalence of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase deficiency and blood-type incompatibility in sub-Saharan Africa: a systematic review and meta-analysis

Yared Asmare Aynalem  1 , Getaneh Baye Mulu  1 , Tadesse Yirga Akalu  2 , Wondimeneh Shibabaw Shiferaw  1
Affiliations

Prevalence of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase deficiency and blood-type incompatibility in sub-Saharan Africa: a systematic review and meta-analysis

Yared Asmare Aynalem et al. BMJ Paediatr Open. .

Abstract

Background: Hyperbilirubinaemia is a silent cause of newborn disease and death worldwide. However, studies of the disease in sub-Saharan Africa are highly variable with respect to its prevalence. Hence, this study aimed to estimate the overall magnitude of neonatal hyperbilirubinaemia and its association with glucose-6-phosphate dehydrogenase (G6PD) deficiency and blood-type incompatibility in sub-Saharan Africa.

Methods: PubMed, Scopus, Google Scholar and the Cochrane Review were systematically searched online to retrieve hyperbilirubinaemia-related articles. All observational studies reported the prevalence of hyperbilirubinaemia in sub-Saharan Africa were included for analysis and excluded if the study failed to determine the desired outcome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Heterogeneity across the included studies was evaluated using the inconsistency index (I2). Subgroup and meta- regression analysis were also done. Publication bias was examined by funnel plot and the Egger's regression test. The random-effect model was fitted to estimate the pooled prevalence of neonatal hyperbilirubinaemia. The meta-analysis was performed using the STATA V.14 software.

Results: A total of 30 486 studies were collected from the different databases and 10 articles were included for the final analysis. The overall magnitude of neonatal hyperbilirubinaemia was 28.08% (95% CI20.23 to 35.94, I2=83.2) in sub-Saharan Africa. Neonates with G6PD deficiency (OR 2.42, 95% CI 1.64 to 3.56, I2=37%) and neonates that had a blood type that was incompatible with their mother's (OR 3.3, (95% CI 1.96 to 5.72, I2=84%) were more likely to develop hyperbilirubinaemia.

Conclusion: The failure to prevent and screen G6PD deficiency and blood-type incompatibility with their mother's results in high burden of neonatal hyperbilirubinaemia in sub-Saharan Africa. Therefore, early identification and care strategies should be developed to the affected neonates with G6PD deficiency and blood-type incompatibility with their mother's to address long-term medical and scholastic damages among those exposed to hyperbilirubinaemia.

Keywords: jaundice; neonatology; nursing Care; qualitative research; statistics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of how research articles were searched and selected for analysis in this study.
Figure 2
Figure 2
Magnitude of neonatal hyperbilirubinaemia in sub-Saharan Africa.
Figure 3
Figure 3
Funnel plot to determine publication bias among the included studies.
Figure 4
Figure 4
The association between G6PD deficiency and neonatal hyperbilirubinaemia in studies from sub-Saharan Africa. G6PD, glucose-6-phosphate dehydrogenase.
Figure 5
Figure 5
The association between blood-type incompatibility and neonatal hyperbilirubinaemia in studies involving sub-Saharan African populations.
See this image and copyright information in PMC

References

    1. Olusanya BO, Kaplan M, Hansen TWR. Neonatal hyperbilirubinaemia: a global perspective. Lancet Child Adolesc Health 2018;2:610–20. 10.1016/S2352-4642(18)30139-1 - DOI - PubMed
    1. Pace EJ, Brown CM, DeGeorge KC. Neonatal hyperbilirubinemia: an evidence-based approach. J Fam Pract 2019;68:E4–11. - PubMed
    1. Wright CJ, Posencheg MA. Neonatal hyperbilirubinemia. fundamentals of pediatric surgery. Springer, 2011: 561–6.
    1. Mutombo AK, Mukuku O, Kabulo BK, et al. Ictères pathologiques du nouveau-né à l’hôpital Bonzola de Mbuji-Mayi, République Démocratique du Congo. Pan Afr Med J 2014;19 10.11604/pamj.2014.19.302.5658 - DOI - PMC - PubMed
    1. Wolf MJ, Beunen G, Casaer P, et al. Extreme hyperbilirubinaemia in Zimbabwean neonates: neurodevelopmental outcome at 4 months. Eur J Pediatr 1997;156:803–7. 10.1007/s004310050718 - DOI - PubMed

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