IGNORANCE of mothers and poor awareness among health caregivers have been identified as reasons why jaundice deforms or kills at least one in every 20 Nigerian neonates or newborn babies.
While mothers still misrepresent the deadly disease and delay medical care, many caregivers are still unaware of the emergency and mode of care necessary for good outcome.
Paediatricians made this submission at a training workshop for Lagos State Primary Healthcare Centre (LSPHC) nurses, calling for improved training for midwives, especially in the rural areas, to reduce Maternal Mortality Rate (MMR) and lifelong disabilities.
Neonatal jaundice, the experts noted, is yellow discolouration of the skill caused by increased levels of bilirubin in the blood. It occurs in 70 per cent term and 80 per cent preterm babies, but bilirubin normally drops to a low level without any intervention required; where it does not, it leads to jaundice.
A paediatrician, Dr. Efunbo Dosekun noted that in cases where bilirubin rises higher, a brain-damaging condition (kernicterus) could occur, leading to significant lifelong disability like deafness, learning difficulties and trauma of stigmatisation for the mother.
The paediatrician with over three decades of experience said that there are still socio-cultural practices and religious beliefs that delay quick response to jaundice care in this part of the world.
She observed that the several home-designed forms of treatment have not helped babies born with jaundice in our communities. These include feeding the baby with pawpaw leaves; herbal drinks, placing the baby in early morning sun etc.
Dosekun, who is also the Chief Medical Director (CMD) of Outreach Children Hospital, FESTAC Town, Lagos added that while causes of the neonatal jaundice are ranging, nurses must be aware that there is standard screening for jaundice in babies.
This, according to her, requires that the bilirubin level in babies be clinically measured and then treated under phototherapy lamps amid outlook for other infections like anaemia.
The treatment for severe jaundice where serum bilibirum level exceeds 20mg per DL is blood transfusion. While this is a time consuming and potentially hazardous, the baby can still have brain damage after the procedure.
She added that nurses, whom she called “change agents” must also know when “babies are handling well” and be sensitive to their needs. “We need to be careful when cases are referred from the Traditional Birth Attendants (TBAs) and private hospitals because of their level of care that might have overlooked screening for conditions like jaundice,” she said.
Dr. Nneka Osai stressed that early detection would prevent the progression of severe jaundice and thereby reduce disabilities and deaths.
Displaying how an advanced technology called Transcutenous Bilirubinmeter (TBM) is used, she explained that while blood test is the standard measure for accuracy, TBM is more efficient as it involves no blood, infection and gives immediate result that is also reliable.
Nurses from the 52 PHCs and officials of the LSPHC board attended the workshop organised by Anu Dosekun Healthcare Foundation (ADHF) and Jaundice in Babies Awareness (JIBA) campaign.
ADHF Project Manager, Ruth Olomu said that the foundation is currently conducting epidemiology survey, awareness campaign, free jaundice screening and treatment of mild to moderate jaundice, partnering with the Lagos State government.
Assistant Director Health Education, LSPHC Board, Kamaldeen Balogun, noted that childhood disease is the major work of medical personnel in the health centres, for which the PHCs have been established as first point of call. “Capacity building, training and retraining are therefore key to improve on the level of awareness.”
One of the participants from Bariga PHC, Mrs. Hanah Ilesanmi said that the training had enlightened her to know the implications of late detection of jaundice.
She added: “I am really surprised that there is a foundation like this that is making efforts to help poor people. It has encouraged me to also give my best as support in the noble course of helping humanity,” Ilesanmi said.
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