Treatment Outcome of Jaundice and Its Associated Factors Among Neonates Treated in Neonatal Intensive Care Unit of Comprehensive and Specialized Hospitals of Southern Nations Nationalities and Peoples Region, Ethiopia 2022

Abstract

Introduction

Jaundice is a common problem that affects up to 50–60% of full-term babies and 80% of preterm babies. It is a benign condition, but sometimes it can cause profound complications and eventually death. Identifying the treatment outcome of jaundice and the factors affecting it is crucial to preventing the death associated with it.

Objective

To determine the treatment outcome of jaundice and its associated factors among neonates treated in neonatal intensive care unit of comprehensive and specialized hospitals of SNNPR, Ethiopia, 2022.

Methods

An institution-based retrospective follow up study was conducted from April 2018 to April 2022. The data was checked for completeness and then entered into Epi-data version 4.6 and exported to STATA version 17. The results were presented in frequencies and percentages for categorical variables as well as mean and median for continuous variables. A binary logistic regression model was used to estimate the effect of an independent variable and the outcome variable.

Results

A total of 423 charts were reviewed, and 416 (98%) were included in the final analysis. Almost 91.3% (95% CI: 88.2, 93.7) of neonates had improved. Factors significantly associated with the treatment outcome were: residence (AOR = 0.36, 95% CI: 0.2, 0.8); origin of admission (AOR = 0.35, 95% CI: 0.2, 0.8); gestational age (AOR = 0.26, 95% CI: 0.1, 0.8); and total serum bilirubin level (AOR = 0.40, 95% CI: 0.2, 0.9).

Conclusion and Recommendation

Improvement was lower compared to other low and middle-income countries; more emphasis should be given to improving treatment outcomes in hospitals.

Keywords:

• hyperbilirubinemia
• jaundice
• neonate
• treatment outcome

Abbreviations

AAP, American Academy of Pediatrics; ABE, Acute Bilirubin Encephalopathy; AOR, Adjusted Odds Ratio; BSc, Bachelor of Science; COR, Crude Odds Ratio; EBT, Exchange Blood Transfusion; G6PD, Glucose-6-Phosphate Dehydrogenase; IQR, Interquartile Range; LED, Light Emitting Diode; LMICs, Low and Middle Income Countries; MSc, Master of Science; NICE, National Institute for Health and Care Excellence; NICU, Neonatal Intensive Care Unit; PCHN, Pediatrics and Child Health Nursing; PDA, Patent Ductus Arteriosus; P.O, Post Office; PT, Phototherapy; SD, Standard Deviation; SNJ, Severe Neonatal Jaundice; SNNPR, Southern Nations Nationalities and Peoples Region; TcB, Transcutaneous Bilirubin; TSB, Total serum Bilirubin; UK, United Kingdom; WCUSH, Wachamo University Comprehensive Specialized Hospital; WSUCSH, Wolaita Sodo University Comprehensive Specialized Hospital.

Data Sharing Statement

Data that supports the study’s findings is available upon reasonable request of the corresponding author.

Ethical Consideration and Patient Privacy

The study was carried out after getting ethical clearance from the ethical clearance committee of the school of nursing on behalf of the Ethical Review Board of the University of Gondar (PCHN/720). After reviewing the ethical clearance, the chief clinical director of each hospital ordered to contact with the NICU head. Data collection began after getting permission from the neonatal intensive care unit head.

By removing names and other identifiers from the data extraction tool, patients’ information was kept private. So this work complied with the Declaration of the Helsinki.

Acknowledgment

I am grateful to the University of Gondar, the College of Medicine and Health Science, the School of Nursing, and the Department of Pediatrics and Child Health Nursing for their guidance and willingness to provide me with the opportunity to conduct research.

I would like to express my gratitude to my advisors, Mrs. Beletech Fentie and Mrs. Bethelihem Tigabu, for their invaluable advice and assistance throughout the research process.

I would also like to express my appreciation to Wolaita Sodo and Wachamo University comprehensive specialized hospitals for their willingness to accept my request to collect data in their hospitals. I would also like to thank the clinical directors, NICU ward head, and data collectors who were working in the institutions for their invaluable support.

Finally, I’d like to express my heartfelt gratitude to my family for their appreciation and support, which gave me the strength to pursue this wonderful opportunity.

Disclosure

The authors report no conflicts of interest in this work.