Home-use icterometry in neonatal hyperbilirubinaemia: Cluster-randomised controlled trial in Vietnam

J Paediatr Child Health. 2014 Sep;50(9):674-9. doi: 10.1111/jpc.12611. Epub 2014 Jun 2.


Aim: To determine whether home-use icterometry improves parental recognition of neonatal jaundice, early care seeking and treatment to minimize risks of bilirubin encephalopathy.

Methods: Cluster-randomised controlled trial of community-level icterometry used at home by mothers in Chi Linh, Vietnam. Rural health-care workers identified and enrolled term newborns. Post-partum mothers received jaundice education and icterometry instructions and were cluster-randomised by commune. Cases received icterometers (icterometer group (IG)) and controls did not (control group (CG)). Subjects received mobile telephone calls from post-natal days 2-7 to determine maternal recognition by visual inspection and icterometer detection of jaundice (≥ 3.0 on five-point scale). Mothers without telephones, premature newborns (<35 weeks) or newborns hospitalised >5 days were excluded.

Results: Three hundred fifty-two subjects were enrolled (183 IG and 169 CG), of whom 11 (3.4%) were lost to telephone follow-up. Jaundice was recognised and/or detected in 94 (27%) of all newborns. Icterometry helped 11 mothers (6%) detect neonatal jaundice that was not visually recognised by IG mothers. Detection by IG mothers was not statistically greater than CG mothers (P = 0.09). Follow-up care seeking was 8% in both groups (P = 0.2), and 11% of jaundiced newborns received treatment (9% IG vs. 16% CG, P = 0.3). Newborns who received care had bilirubin measurements that averaged 257 μmol/L IG vs. 322 μmol/L CG (P = 0.3). There were no deaths.

Conclusions: In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.

Keywords: community medicine; developing country; hyperbilirubinaemia; newborn; parent education; screening.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bilirubin / blood
  • Cluster Analysis
  • Community Medicine
  • Dermatology / instrumentation*
  • Female
  • Gestational Age
  • Home Nursing / methods*
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / diagnosis*
  • Male
  • Neonatal Screening / methods*
  • Pilot Projects
  • Rural Population
  • Skin Pigmentation*
  • Vietnam
  • Young Adult


  • Bilirubin