Does Maternal Instruction Prevent Kernicterus in Nigeria?
Does Maternal Instruction Prevent Kernicterus in Nigeria?
This study examines (a) whether introduction of public, health provider, and maternal
 education about risks of jaundice will decrease the occurrence of ABE compared with baseline
 prevalence (before-after design) or (b) whether antenatal or postpartum instruction to
 mothers will decrease the incidence of ABE compared with those who did not received
 instruction (concurrent opportunistic controls in phase 2).
This 2 phase study first determines the prevalence of acute bilirubin encephalopathy (ABE)
 among newborns admitted for treatment of jaundice at 5 regional centers in Nigeria and
 identifies social/behavioral/medical factors associated with ABE. Information gained in phase
 1 identified high risk sub-populations and guided selection of instructional materials for
 phase 2. Core data sheets submitted monthly by participating centers included clinical data,
 demographic information, number of antenatal clinic visits, birth place (hospital, clinic,
 home) and attendant, distance from care centers and reasons for delay, if any, in seeking
 care. Receipt of jaundice instruction by mothers is self-reported. Statistical analysis
 includes Chi square and logistic regression analysis of risk factors. Sample size: 1,000
 subjects in each phase are required to demonstrate a 20% decrease in disease prevalence
 (baseline ABE incidence anticipated to be 15% of jaundiced babies) at 95% confidence level.
Inclusion Criteria:

 -  Newborn infant receiving treatment for neonatal jaundice

 Exclusion Criteria:

 -  Non-viable premature infants

 -  Severe congenital defects.

 -  Postnatal age greater than 21 days