Evaluation of a transcutaneous bilirubinometer among neonatal jaundice in a tertiary health care provider

Neonatal jaundice has long been associated with kernicterus, a severe neurological damage of the brain if late detection. Emerging point of care modalities such as transcutaneous devices replaces laboratory measures for screening neonatal jaundice. Transcutaneous bilirubinometer (TcB) improves patient management and care by reducing turnaround time and invasive blood sampling. Implementing a TcB may prevent this neurological sequela by early initiation of treatment. Currently, local clinical practice guidelines suggest the utilisation of TcB for detecting neonatal jaundice due to the device's high sensitivity and good correlation with the gold standard. Relating to the current usage of TcB, a prospective cross-sectional study was performed to determine the accuracy and reliability of TcB against total serum bilirubin (TSB) among neonatal jaundice in a tertiary health care provider. Randomly selected term or near- term neonatal jaundice infants admitted or noted as jaundiced between March and June 2021 were recruited. Both sternum and forehead transcutaneous bilirubin measurements were taken for each recruited infant and compared to TSB. Data collected were analysed using SPSS version 22. This study found that TcB is an accurate and reliable device with a sensitivity of 96.2% and 92.5% for sternum and forehead measurements, respectively. Evidence follows low false negatives results, a good correlation (0.89<r>0.93), and moderate to substantial agreement of the device compared to TSB. This study did not specify any cut-off value of TcB for reflex TSB testing. A low cut- off value at 150 µmol/L may increase TSB measurement and indirectly burden healthcare costs. This study recommends the utilisation of TcB as a screening tool for jaundice detection and using the TcB cut-off as previously suggested in local clinical practice guidelines for jaundice management.