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New app can identify severe jaundice in newborns

It is much more reliable than just looking and can give early diagnoses that then require treatment.

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Newborn baby boy under phototherapy lamp. getting treated for jaundice
(True Touch Lifestyle via Shutterstock)

By Danny Halpin via SWNS

A new smartphone app which identifies severe jaundice in newborn babies by scanning their eyes could save lives, according to a new study.

The app, called neoSCB, developed by the University College London (UCL) scientists with colleagues at the University of Ghana, was used it to screen for jaundice in more than 300 newborn babies in Ghana.

It follows an initial pilot study on 37 newborns at University College London Hospital (UCLH) in 2020.

For the large-scale study, published in the journal Pediatrics, the team tested over 300 babies with the app, measuring the yellowness of the white part of the eye (sclera) which is a sign of neonatal jaundice.

It is much more reliable than just looking and can give early diagnoses that then require treatment.

The study compared how effective the neoSCB app was compared with conventional screening methods.

Of the 336 babies tested by the app, 79 were severely jaundiced newborns, and the app correctly identified 74 of them.

This level of accuracy is consistent with the most common conventional screening method, a non-invasive device known as a transcutaneous bilirubinometer, which correctly identified 76.

The transcutaneous bilirubinometer works by measuring the yellow pigment under the newborn’s skin to give a reading on jaundice levels.

Screening results are then followed up with blood tests to work out which type of treatment will be required.

UCL's Dr Terence Leung, who developed the technology behind the app, said: “The study shows that the neoSCB app is as good as commercial devices currently recommended to screen for severely jaundiced newborns.

“We hope that, once rolled out widely, our technology can be used to save the lives of newborns in parts of the world that lack access to expensive screening devices.”

Study lead Dr. Christabel Enweronu-Laryea, of the University of Ghana, said: “The neoSCB method was acceptable to mothers in urban and rural communities where the study was conducted.

“Mothers easily devised ways to keep the baby’s eyes open, most often by initiating breastfeeding.”

Jaundice, where the skin and whites of the eye turn yellow, is common in newborns and is usually harmless.

The yellowness is caused by a substance called bilirubin, which in severe cases can enter the brain, leading to death or disabilities such as hearing loss, neurological conditions such as athetoid cerebral palsy and developmental delays.

Every year severe jaundice causes about 114,000 newborn deaths and 178,000 cases of disability worldwide, despite it being a treatable condition.

Most cases of neonatal jaundice occur in the first week after birth and routine screening for early diagnosis in higher income countries has reduced the risks of severe complications.

But it is newborns in low- and middle-income countries who are at a greater risk of severe jaundice, or neonatal hyperbilirubinemia, because of the lack of resources required for screening.

A commercial transcutaneous bilirubinometer costs around £4,000 ($5,031) a device and blood tests need a large storage capacity.

Other things like more home births and early postnatal discharge can mean fewer newborns go through screening.

Babies in sub-Saharan Africa also face a greater risk because there is a high prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency.

It is an inherited genetic disorder which comes with an increased risk of severe jaundice and of hemolysis, where red blood cells break down faster than they are made.

Senior author Dr. Judith Meek, of UCLH, added: “This app has the potential to prevent death and disability worldwide in many different settings.

"It will reduce unnecessary hospital visits and potentially empower community health workers and parents to care for newborn babies safely.”

In total, 724 newborns aged up to 28 days were initially considered for the study. The 336 whose datasets were used for the paper had had no prior treatment for jaundice.

Babies who were born at less than 35 weeks, were critically ill or had a very low birth weight were excluded from the final study.

The app was tested with frontline healthcare workers and the babies’ mothers, who provided feedback on the usability of the app.

The study was supported by the Saving Lives at Birth consortium and the EPSRC UCL Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare.

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