Follow-up of Children with Kernicterus in Kano, Nigeria

• Published in: Journal of tropical pediatrics (1980) Vol. 64; no. 3; p. 176
• Main Authors: Farouk, Zubaida Ladan, Muhammed, Abdussalam, Gambo, Safiya, Mukhtar-Yola, Maria, Umar Abdullahi, Shehu, Slusher, Tina M
• Format: Journal Article
• Language: English
• Published: England 01.06.2018
• Subjects: Bilirubin - blood; Child; Developmental Disabilities - epidemiology; Developmental Disabilities - physiopathology; Female; Follow-Up Studies; Humans; Hyperbilirubinemia - epidemiology; Infant; Infant, Newborn; Jaundice, Neonatal - diagnosis; Jaundice, Neonatal - epidemiology; Kernicterus - diagnosis; Kernicterus - epidemiology; Male; Morbidity; Mortality; Neurologic Examination; Nigeria - epidemiology; Prevalence; Prospective Studies; Nigeria
• ISSN: 1465-3664
• DOI: 10.1093/tropej/fmx041

Acute bilirubin encephalopathy (ABE) is associated with long-term sequelae (kernicterus). It continues to be a significant issue in our region of Nigeria, accounting for much morbidity and mortality. Herein we report the outcome of neonates with ABE seen at our centre. We established a surveillance of children who had ABE and returned to follow-up from prospective cases of ABE (2012-2014). ABE was diagnosed based on a bilirubin-induced neurologic dysfunction score of ≥ 1. Kernicterus was subsequently established based on a history of developmental delays, hearing impairments and abnormal physical and neurologic examinations at follow-up age ≥3 months. Five hundred fifty-one neonates had hyperbilirubinaemia of whom 104 (18.8%) had ABE. Mean transcutaneous bilirubin using the Ingram icterometer was 18.3 mg/dl  ±  SD 1.9 [(12.5-19.1), total serum bilirubin of 18.1 ± 10.9] (range: 10.3-64 mg/dl). Sixty-five infants returned for follow-up (41 males and 24 females); mean age 9 months (22 days to 17 months). Most (58 of 65; 89.2%) had abnormal neurological findings and 15 (25.9%) had probable kernicterus. There is a critical need for a National Kernicterus Registry to document all cases of kernicterus and formulate an effective treatment and prevention policy.