- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02613676
Transcutaneous Screening for Risk of Severe Hyperbilirubinemia in South African Newborns
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Like in many other countries in Africa and the rest of the world, objective screening for risk of severe hyperbilirubinemia using serum bilirubin (TsB) or transcutaneous bilirubin (TcB) measurement is currently not standard of care in South Africa. The investigators therefore propose to test the use of a non-invasive TcB device to detect and predict the risk of severe jaundice before discharge of babies from the new-born nursery in a South African population of newborns.
OBJECTIVE To evaluate the effects of transcutaneous bilirubin screening in newborns before hospital discharge.
METHODS In this randomised controlled trial (RCT) the investigators will compare the traditional visual assessment and TcB measurement before hospital discharge. About 1858 newborns ≥35 weeks gestational age and/or ≥1800 g, who are <72 hrs of life will be randomly allocated into two groups: a) TcB screening, or b) visual assessment (standard care)
Subjects:
Babies ≥ 35 wks gestational age and/or ≥ 1800g, who are <72 hrs of life.
Study arms:
Participants will be randomised within 72 hrs of birth into: a) TcB screening plotted on the nomogram or b) visual assessment of jaundice.
Control group (Standard care):
In this group, participants will be assessed for jaundice by the use of the traditional visual assessment before discharge. A formal serum bilirubin level will be done on all infants who are visibly jaundiced and decide on need for phototherapy.
TcB screening group:
All participants in this group, will be assessed for the risk of severe hyperbilirubinemia by measurement of bilirubin level using the JM 105 transcutaneous device at < 72 hrs of life before hospital discharge. The bilirubin level will be plotted on the Bhutani hour-specific nomogram to determine the risk zone. Babies will be classified into four different different risk categories: high-risk, high-intermediate, low-intermediate and low risk categories depending on the transcutaneous bilirubin level. Follow-up or intervention will be planned based on the risk category. For participants who are identified as high risk for severe hyperbilirubinemia, the investigators will perform a formal TsB measurement and determine need for phototherapy.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Western Cape
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Cape Town, Western Cape, South Africa, 7560
- Tygerberg Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- All newborns ≥ 35 wks gestational age and ≥ 1800g
- Babies who who are < 72 hours of life
Exclusion Criteria:
- Prior use of phototherapy
- Major congenital anomaly
- Babies born < 35 wks gestational age or < 1800g
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TcB screening before discharge
Participants in this group will be screened for jaundice using the JM 105 transcutaneous device.
The TcB value will be plotted on the Bhutani nomogram to assess the risk category.
Infants who are categorised as high risk according to the nomogram will require blood sampling for TsB and assessment for need for phototherapy.
|
Transcutaneous bilirubin screening before hospital discharge and assessment of risk category according to the Bhutani nomogram
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Other: Standard care (visual inspection)
Participants in this group will be managed routinely according to the current standard of care where babies are assessed for jaundice by visual inspection.
Babies in this group will require blood draw for TsB if there are visibly jaundiced
|
Participants in this group will be assessed for jaundice by visual inspection.
Blood draw for TsB will be drawn only if the participant is visibly jaundiced.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Readmission for hyperbilirubinemia
Time Frame: Up to two weeks
|
The primary outcome is readmission for hyperbilirubinemia requiring phototherapy or exchange transfusion
|
Up to two weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phototherapy before discharge
Time Frame: Up to two weeks
|
This outcome refers to the use of phototherapy for the treatment of hyperbilirubinemia before hospital discharge.
|
Up to two weeks
|
TsB > 427 umol/l or TsB > threshold for exchange transfusion
Time Frame: Up to two weeks
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Up to two weeks
|
|
Length of hospital stay (days)
Time Frame: Up to two weeks
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Up to two weeks
|
|
Blood draw for total serum bilirubin
Time Frame: Up to two week
|
This outcome refers to blood sampling for laboratory measurement of TsB
|
Up to two week
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Vinod K Bhutani, MD, Stanford University
- Principal Investigator: Charles I Okwundu, MBBS, MPH, University of Stellenbosch
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- TcBScreening
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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