Cargando…

Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings

Newborns are at increased risk of jaundice, a condition in which excess bilirubin accumulates in blood. Left untreated, jaundice can lead to neurological impairment and death. Jaundice resulting from unconjugated hyperbilirubinemia is easily treated with exposure to blue light, and phototherapy syst...

Descripción completa

Detalles Bibliográficos
Autores principales: Keahey, Pelham A., Simeral, Mathieu L., Schroder, Kristofer J., Bond, Meaghan M., Mtenthaonnga, Prince J., Miros, Robert H., Dube, Queen, Richards-Kortum, Rebecca R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: National Academy of Sciences 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754796/
https://www.ncbi.nlm.nih.gov/pubmed/29203650
http://dx.doi.org/10.1073/pnas.1714020114
_version_ 1783290486562226176
author Keahey, Pelham A.
Simeral, Mathieu L.
Schroder, Kristofer J.
Bond, Meaghan M.
Mtenthaonnga, Prince J.
Miros, Robert H.
Dube, Queen
Richards-Kortum, Rebecca R.
author_facet Keahey, Pelham A.
Simeral, Mathieu L.
Schroder, Kristofer J.
Bond, Meaghan M.
Mtenthaonnga, Prince J.
Miros, Robert H.
Dube, Queen
Richards-Kortum, Rebecca R.
author_sort Keahey, Pelham A.
collection PubMed
description Newborns are at increased risk of jaundice, a condition in which excess bilirubin accumulates in blood. Left untreated, jaundice can lead to neurological impairment and death. Jaundice resulting from unconjugated hyperbilirubinemia is easily treated with exposure to blue light, and phototherapy systems have been developed for low-resource settings; however, there are no appropriate solutions to diagnose and monitor jaundice in these settings. To address this need we present BiliSpec, a low-cost reader and disposable lateral flow card designed to measure the concentration of total bilirubin from several drops of blood at the point of care. We evaluated the performance of BiliSpec, using blood from normal volunteers spiked with varying amounts of bilirubin; results measured using BiliSpec correlated well with a reference laboratory bilirubinometer (r = 0.996). We then performed a pilot clinical study using BiliSpec to measure total bilirubin in neonates at risk for jaundice at Queen Elizabeth Central Hospital in Blantyre, Malawi. Concentrations measured using BiliSpec correlated well with those measured using a laboratory reference standard in 94 patient samples ranging from 1.1 mg/dL to 23.0 mg/dL in concentration (r = 0.973). The mean difference between bilirubin levels measured with BiliSpec and the reference standard was 0.3 mg/dL (95 [Formula: see text] CI: −1.7–2.2 mg/dL).
format Online
Article
Text
id pubmed-5754796
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher National Academy of Sciences
record_format MEDLINE/PubMed
spelling pubmed-57547962018-01-08 Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings Keahey, Pelham A. Simeral, Mathieu L. Schroder, Kristofer J. Bond, Meaghan M. Mtenthaonnga, Prince J. Miros, Robert H. Dube, Queen Richards-Kortum, Rebecca R. Proc Natl Acad Sci U S A PNAS Plus Newborns are at increased risk of jaundice, a condition in which excess bilirubin accumulates in blood. Left untreated, jaundice can lead to neurological impairment and death. Jaundice resulting from unconjugated hyperbilirubinemia is easily treated with exposure to blue light, and phototherapy systems have been developed for low-resource settings; however, there are no appropriate solutions to diagnose and monitor jaundice in these settings. To address this need we present BiliSpec, a low-cost reader and disposable lateral flow card designed to measure the concentration of total bilirubin from several drops of blood at the point of care. We evaluated the performance of BiliSpec, using blood from normal volunteers spiked with varying amounts of bilirubin; results measured using BiliSpec correlated well with a reference laboratory bilirubinometer (r = 0.996). We then performed a pilot clinical study using BiliSpec to measure total bilirubin in neonates at risk for jaundice at Queen Elizabeth Central Hospital in Blantyre, Malawi. Concentrations measured using BiliSpec correlated well with those measured using a laboratory reference standard in 94 patient samples ranging from 1.1 mg/dL to 23.0 mg/dL in concentration (r = 0.973). The mean difference between bilirubin levels measured with BiliSpec and the reference standard was 0.3 mg/dL (95 [Formula: see text] CI: −1.7–2.2 mg/dL). National Academy of Sciences 2017-12-19 2017-12-04 /pmc/articles/PMC5754796/ /pubmed/29203650 http://dx.doi.org/10.1073/pnas.1714020114 Text en Copyright © 2017 the Author(s). Published by PNAS. https://creativecommons.org/licenses/by-nc-nd/4.0/ This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle PNAS Plus
Keahey, Pelham A.
Simeral, Mathieu L.
Schroder, Kristofer J.
Bond, Meaghan M.
Mtenthaonnga, Prince J.
Miros, Robert H.
Dube, Queen
Richards-Kortum, Rebecca R.
Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title_full Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title_fullStr Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title_full_unstemmed Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title_short Point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
title_sort point-of-care device to diagnose and monitor neonatal jaundice in low-resource settings
topic PNAS Plus
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5754796/
https://www.ncbi.nlm.nih.gov/pubmed/29203650
http://dx.doi.org/10.1073/pnas.1714020114
work_keys_str_mv AT keaheypelhama pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT simeralmathieul pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT schroderkristoferj pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT bondmeaghanm pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT mtenthaonngaprincej pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT mirosroberth pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT dubequeen pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings
AT richardskortumrebeccar pointofcaredevicetodiagnoseandmonitorneonataljaundiceinlowresourcesettings