Evaluation of the Bilicheck®transcutaneous bilirubinometer in jaundiced Nigerian term andpreterm neonates

Abstract

Background: Transcutaneous bilirubinometry has shown some promise as a safe, non-invasive method that correlates well with traditional laboratory methods of estimating serum bilirubin. However there is a paucity of studies done on neonates of African descent. Aim: The aim of the study was to evaluate the diagnostic performance of the Bilichek® transcutaneous bilirubinometer in jaundiced Nigerian term and preterm neonates. Methods: This was a cross- sectional study involving 169 jaundiced preterm and term neonates studied over a 4 month period. A total of 200 transcutaneous bilirubin (TcB) readings determined using the Bilichek® device were obtained simultaneously with total serum bilirubin (TSB) readings determined by the diazo method. Results: The mean (SD) difference between TcB and TSB was 1.5 (2.6) mg/dL (95% CI of 1.2 - 1.9 mg/dL); p= 0.000. There was strong correlation between TcB and TSB with a correlation coefficient (r) of 0.77 (p = 0.000). The 95% limits of agreement were between -3.5mg/dL and 6.6mg/dL. There was poor correlation between TcB and TSB of r= 0.43 at high TSB levels >12mg/dl. The TcB cut-off that most accurately predicted TSB was 11.7mg/dL. Conclusion: Transcutaneous bilirubinometry is a reliable screening method for assessing severity of hyperbilirubinaemia in black African neonates. However, due to the occurrence of wide disparities, confirmatory serum bilirubin measurements should be done for TcB values above 11.7mg/dL.