Diagnostic accuracy of transcutaneous bilirubinometry and icterometry compared with capillary bilirubin measurement in neonates with jaundice in Bhutan: a cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background : Neonatal jaundice is a very common condition occurring worldwide and is reported to be more prevalent in Asian neonates. It is one of the main reasons for hospital admissions and neonatal morbidity especially during the first week of life. Gold standard for diagnosis of hyperbilirubinemia is investigation of Total serum bilirubin; however, this procedure is invasive and painful. So, a non-invasive and painless screening method is required to be explored and implemented in low resource setting to reduce morbidity and mortality related to neonatal hyperbilirubinemia. Objectives : To determine the accuracy of transcutaneous bilirubinometer (TCB) and icterometer in comparison with capillary bilirubin measurement in neonates with jaundice at the National Referral Hospital, Thimphu. Methods : A cross sectional study was conducted among 723 neonates with hyperbilirubinemia at National Referral Hospital, Thimphu from December 2021 to November 2022. Transcutaneous bilirubinometer and Icterometer measurements were obtained from the neonates for whom the capillary bilirubin measurement was advised. Diagnostic accuracy was assessed using correlation analysis and receiver operating characteristic (ROC) curves. Results : Out of 723 neonates, 55.7% were males and 44.3% were females. There was strong correlation between transcutaneous bilirubinometer and capillary bilirubin (r = 0.72379) with statistically significant p-value of < 0.001). However, TCB values on average overestimated the capillary bilirubin value by 6.2 mg/dl. TCB cut- off ≥ 21 mg/dl demonstrated the best sensitivity (100%) and specificity (84%) for identifying capillary bilirubin measurement ≥ 17 mg/dl with excellent AUC of 0.9123. Although the comparison of the icterometer measurements and the capillary bilirubin showed a statistically significant relation (p < 0.001), the correlation was moderately strong (r = 0.62). The analysis of ROC curve showed 100% sensitivity and 51% specificity for icterometer score of ≥ 3 for identifying capillary bilirubin measurement ≥ 17 mg/dl with good AUC of 0.8849. The icterometer also performed reasonably well compared to capillary bilirubin (score ≥ 3: sensitivity 85% and specificity 56% for capillary bilirubin measurement of ≥ 13 mg/dl.). Conclusion : TCB demonstrated higher diagnostic accuracy than the icterometer. However, the icterometer may serve as a useful screening tool in resource-limited settings where TCB is unavailable.
Source: BMC Pediatrics
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7160823830