P0266 - Neonatal Jaundice: Knowledge Gaps of Medical Providers and Trainees in Southwest, Nigeria

Introduction: Gains in child mortality in low- and middle-income countries (LMICs) over the past decade have not resulted in a commensurate reduction in neonatal mortality. Severe neonatal jaundice (NNJ) is a leading cause of neonatal morbidity and mortality in LMICs. Risk mitigation and management modalities for NNJ are well documented and in high-income countries have led to a marked reduction in complications but not in LMICs. Data on the knowledge base of medical in LMICs is extremely limited. Our study aimed to collect information regarding knowledge of NNJ among medical practitioners and trainees in a semi-rural area of southwestern Nigeria.

Methods: This cross-sectional study was conducted in Ogbomosho, Nigeria from November 2016 to January 2017. Respondents completed the survey after verbal informed consent was obtained. Data analysis was performed using STATA 15 and SAS 9.4 (SAS Institute Inc. Cary, NC, USA).

Results: Our sample was composed of nurse midwives (33.4%), nurses (18.6%), nursing students (15.2%), traditional birth attendants (TBAs) (12.7%), physicians (10.2%), and medical students (9.9%). As noted in Table 1, most physicians were aware of the common causes of NNJ however the knowledge gaps in most other groups were significant with many not recognizing the three most common causes of NNJ in Nigeria (G6PD deficiency, ABO/Blood group incompatibility, and sepsis/infection). Although G6PD is the leading cause of severe NNJ, affecting 15-26% of males in Nigeria very few of the healthcare providers recognized that it is common in Nigerians (33% of physicians, 3% of nurses, 26% of midwives, 12% of TBA’s, 47% of medical students and 18% of nursing students or that is can cause severe NNJ (91% of physicians, 60% of nurses, 71% of midwives, 7% of TBA’s, 81% of medical students and 43% of nursing students. Table 2 highlights the gaps in the knowledge of these same medical providers and trainees regarding the sequela of severe NNJ.

Conclusion: There are significant knowledge gaps about NNJ among medical providers in Ogbomoso, Nigeria. It is likely that these gaps lead to significant deficits in anticipatory guidance for mothers/families as well as gaps in effective prevention, treatment, and follow-up of these children. Opportunities to bridge these gaps exist in all these groups of healthcare providers from the physicians and nurses/midwives beginning in their training as well as the training of TBA’s and the mothers themselves. The knowledge gaps must be addressed if we are to eliminate these tragic and preventable complications from severe NNJ in Nigeria and in other LMICs.