Current and emerging technologies for the timely screening and diagnosis of neonatal jaundice

Abstract

Neonatal jaundice is one of the most common clinical conditions affecting newborns. For most newborns, jaundice is harmless, however, a proportion of newborns develops severe neonatal jaundice requiring therapeutic interventions, accentuating the need to have reliable and accurate screening tools for timely recognition across different health settings. The gold standard method in diagnosing jaundice involves a blood test and requires specialized hospital-based laboratory instruments. Despite technological advancements in point-of-care laboratory medicine, there is limited accessibility of the specialized devices and sample stability in geographically remote areas. Lack of suitable testing options leads to delays in timely diagnosis and treatment of clinically significant jaundice in developed and developing countries alike. There has been an ever-increasing need for a low-cost, simple to use screening technology to improve timely diagnosis and management of neonatal jaundice. Consequently, several point-of-care (POC) devices have been developed to address this concern. This paper aims to review the literature, focusing on emerging technologies in the screening and diagnosing of neonatal jaundice. We report on the challenges associated with the existing screening tools, followed by an overview of emerging sensors currently in pre-clinical development and the emerging POC devices in clinical trials to advance the screening of neonatal jaundice. The benefits offered by emerging POC devices include their ease of use, low cost, and the accessibility of rapid response test results. However, further clinical trials are required to overcome the current limitations of the emerging POC’s before their implementation in clinical settings. Hence, the need for a simple to use, low-cost POC jaundice detection technology for newborns remains an unsolved challenge globally.

Keywords:

• Point-of-care technology
• bilirubin detection
• neonatal jaundice screening

Author contributions

MT prepared the first draft under the supervision of RG and AER. DT contributed expertise in neonatology, in reviewing the manuscript. TPL contributed expertise in laboratory medicine and the overall structure of the manuscript. MCT contributed to reviewing the challenges in the screening of jaundice in low-resource settings. MO reviewed and screened the included references of emerging sensors. All authors contributed to the re-drafting of the manuscript.

Disclosure statement

None of the authors have any financial interests or conflicts of interest to declare. The members of the team are involved in the development of a method of detecting jaundice in neonates using a urine-based testing system.

Additional information

Funding

This study is supported by a National Health and Medical Research Council (NHMRC) Development Grant (GNT1139340) and the Victorian Government Operational Infrastructure Support Program (Melbourne, Australia). AER is supported by an NHMRC Early Career Fellowship (GNT1123030). MT is supported by an RTP Scholarship governed by the University of Melbourne. DGT is supported by a National Health and Medical Research Council Clinical Career Development Fellowship (Grant ID 1053889).