In Countries Lacking Electricity, Filtered Sunlight Could Save Thousands of Newborns
A new low-tech, low-cost cure for jaundice could save thousands of newborns in impoverished countries. Just look to the sky for the answer.
Researchers from Stanford University, the University of Minnesota, and the Massey Street Children’s Hospital in Lagos, Nigeria, have developed sunlight-filtering canopies to treat the condition in newborns. This new affordable option relies on sheets of plastic film and the sun because traditional phototherapy, which requires neonatal incubators and ultraviolet bulbs, isn’t always possible in developing countries.
“This is an easy solution to a serious problem,” Dr. David Stevenson, a Stanford professor of pediatrics specializing in neonatal and developmental medicine, told Smithsonian magazine.
According to the Centers for Disease Control and Prevention, about 60 percent of all newborns have jaundice. The disease affects 481,000 newborn infants every year; 114,000 of them die, and 63,000 survive with disabilities. The majority of those infants live in low-income countries, particularly in sub-Saharan Africa.
Jaundice occurs when a chemical called bilirubin builds up in a baby’s blood, causing yellow coloration in the skin. The mother’s liver removes bilirubin for the baby during pregnancy; once the baby is delivered, its liver is expected to start filtering out the chemical on its own. But if the liver is not developed enough, buildup occurs.
Left untreated, severe jaundice can cause kernicterus, a type of brain damage. Other risks include cerebral palsy, deafness, language-processing issues, and developmental delays. Some populations in Africa, Asia, and the Mediterranean have a higher risk of jaundice owing to a genetic condition that helps protect against malaria.
Traditional treatment calls for phototherapy lamps: Babies are placed in an incubator under UV lights. The light breaks down the bilirubin, and the condition is resolved in a few days.
But these plastic canopies have proved to be just as effective in treatment, according to a study published in the New England Journal of Medicine by Stevenson and colleagues. After building and testing plastic canopies in Nigeria, the researchers found that the plastic canopies protect against harmful ultraviolet rays and filter in blue wavelengths needed to treat jaundice.
The results, published in September, showed both types of phototherapy were “highly and similarly efficacious.”
The study included 447 infants with jaundice at the Nigerian hospital; half were treated with standard phototherapy and the others with the canopies. Under the canopies, babies were held by their mothers for a minimum of five hours of daylight.
The canopy treatment was 93 percent effective, and the traditional treatment was 90 percent effective.
The work is the conclusion of a two-part study. The original study found phototherapy using filtered sunlight was safe and effective. The latest results looked at the comparability of the two treatments.
The new therapy method is especially beneficial to low- to medium-income countries, where options for traditional treatment can be scarce.
While phototherapy has long been the traditional treatment for jaundice, the minimal light requirement is frequently unavailable in impoverished countries owing to cost or unreliable electricity. If lamps are not available, a blood transfusion is required, a risky option especially in areas of rural Africa where donor blood could contain AIDS or other blood-transmitted related diseases.
“When you use the sun as your source, that’s reliable,” Stevenson said. “The sun comes out every day. Even when it’s cloudy, the sun is still there.”
Stevenson and his colleagues told the magazine they hope their report encourages health officials in impoverished countries to build their own canopies. They plan to launch a public health campaign to raise awareness about the new therapy treatment.