Treatment of Neonatal Jaundice with Phototherapy in a Resource Constrained Country (Burkina Faso)

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Résumé

Phototherapy is highly effective in prevention of major complications associated with neonatal jaundice.
However, in resource constrained setting, phototherapy treatment in newborns can be very challenging.
The objective was to assess the current situation regarding the treatment of neonatal jaundice using
phototherapy in the pediatric ward of Yalgado Ouedraogo university hospital in Burkina Faso. An
observational survey was conducted between October 2023 and March 2024. All newborns presenting
jaundice and treated with phototherapy were included. Data was collected on the daily basis during
inpatient care.
Of the 2,184 newborns admitted, 168 (7.7%) presented with jaundice and 115 (68%) were treated with
phototherapy. The sex ratio was 1.08. Jaundice was early onset in 53%, generalized in 90%, frank in
87% and pathological in 89%. The main causes of jaundice were neonatal infections (80.9%) and
maternal fetal blood group incompatibility (35.7%). Conventional phototherapy was used intermittently
in all patients. In 20, 9% of newborns, phototherapy was initiated more than 24 hours following jaundice
diagnosis. The number of phototherapy sessions per day was three in 69% of patients. In 69 (71%) cases,
it took more than five days of exposure to phototherapy to leave the danger zone for hyperbilirubinemia
(total mean exposure time to phototherapy 5.17 days +/- 3.6 days).
Conclusion: Phototherapy performance in the treatment of neonatal jaundice was substandard hence the
risk of long-term complications in newborns. There is a need for an efficient phototherapy equipment
while ensuring regular maintenance. In addition, long time follow up of these high-risk newborns must
be reinforced.

Mots-clés

Jaundice; Newborn; Phototherapy; Burkina Faso