A smartphone app that identifies severe jaundice in babies by scanning their eyes could save lives in areas that do not have access to expensive sensing devices, a study co-authored by researchers at UCL (University College London) suggests. the University of Ghana. .
The application, called neoSCB, was developed by UCL doctors and engineers and was used to detect jaundice in more than 300 newborn babies in Ghana, following an initial pilot study of 37 newborns at University College London Hospital (UCLH) in 2020.
For the large-scale study, published in Pediatrics, the team tested more than 300 babies with the app, which analyzes images taken with a smartphone’s camera to quantify the yellow of the white part. of the eye (sclerotic), a sign of neonatal jaundice. Analyzing the yellow of the eye just by looking is unreliable, and the neoSCB application can give an early diagnosis of neonatal jaundice that requires treatment.
The study compared the effectiveness of the neoSCB application with conventional screening methods. Of the 336 babies tested by the app, 79 were babies with severe jaundice and the app correctly identified 74. This is in line with the accuracy of the most common conventional screening method, a non-invasive device known as a transcutaneous bilirubinometer. , which correctly identified 76.
The transcutaneous bilirubinometer works by measuring the yellow pigment under the newborn’s skin to give a measure of jaundice levels. All screening results are then followed by blood tests to determine the type of treatment needed.
Dr. Terence Leung (UCL Medical Physics and Biomedical Engineering), who developed the technology behind the app, said: “The study shows that the neoSCB app is as good as the commercial devices currently recommended for detecting babies with jaundice. But the app only requires a smartphone that costs less than a tenth of the commercial device. of the world who do not have access to expensive detection devices “.
The neoSCB method was acceptable to mothers in urban and rural communities where the study was conducted. Mothers easily devised ways to keep the baby’s eye open, often initiating breastfeeding. “
Dr. Christabel Enweronu-Laryea, lead author of the study, Faculty of Medicine, University of Ghana
Jaundice, where the skin and whites of the eye turn yellow, is common in newborns and is usually harmless. Yellowishness is caused by a substance called bilirubin, which in severe cases can enter the brain, causing death or disability such as hearing loss, neurological conditions such as athetoid cerebral palsy and developmental delays.
Severe jaundice causes about 114,000 newborn deaths and 178,000 cases of disability worldwide each year, despite being a treatable disease. Most cases of neonatal jaundice occur during the first week after birth, and routine screening for early diagnosis in higher-income countries has reduced the risk of serious complications.
Newborns in low- and middle-income countries are at higher risk for severe jaundice or neonatal hyperbilirubinemia, due to a lack of resources for screening. A commercial transcutaneous bilirubinometer typically costs around £ 4,000 per device, and blood tests require a lot of capacity. Additional factors, such as a higher prevalence of home births and early postnatal discharge, may contribute to fewer newborns undergoing screening.
Babies in sub-Saharan Africa are also at higher risk due to a high prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency, which is an inherited genetic disorder associated with an increased risk of haemolysis. red blood cells break down faster than they do, and hyperbilirubinemia.
The lead author, Dr. Judith Meek (UCLH), added: “This app has the potential to prevent death and disability worldwide in many different settings. It will reduce unnecessary hospital visits and potentially empower community health workers and parents to take care of babies safely. “
In total, 724 newborns between 0 and 28 days were initially considered for the study. The 336 data sets used for the document had no previous treatment for jaundice. Babies who were born less than 35 weeks old, were seriously ill, or were very low birth weight were excluded from the final study. The app was tested with front-line health workers and mothers of babies, who provided feedback on the usability of the app.
The study was supported by the Saving Lives at Birth consortium and the UCL EPSRC Center for Integrated Intelligent Doctoral Training in Health Care.
University College London