ArticleBMJ paediatrics open2025
Smartphone-based screening of neonatal jaundice in three populations in low and middle-income countries: a cross-sectional study.
Article in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Advancing neonatal jaundice screening with mHealth: a mixed-methods randomised controlled feasibility study in a resource-limited setting in Mexico.BMJ paediatrics open · 2026Trial
- Accuracy of non-invasive smartphone bilirubin measurements on neonates before and during phototherapy.European journal of pediatrics · 2026Article
- Agreement and diagnostic performance of a smartphone-based bilirubin assessment tool for screening neonatal hyperbilirubinemia.Frontiers in pediatrics · 2026Article
- Neonatal hyperbilirubinemia: past lessons, current practices, and future directions.European journal of pediatrics · 2025Review
- Clinical superiority of artificial intelligence-enabled jaundice monitoring follow-up combined with end-tidal carbon monoxide measurement in neonatal jaundice management.American journal of translational research · 2025Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNeonatal hyperbilirubinemia (NHB) is a significant cause of morbidity and mortality, particularly in low and middle-income countries (LMICs). Transcutaneous bilirubinometers offer a non-invasive method for assessing NHB but have limited availability due to cost and maintenance requirements. Visual assessment of jaundice is shown to be inaccurate. Smartphone-based technologies have the potential to provide innovative and accessible healthcare solutions. This study aimed to evaluate the Picterus system, a smartphone-based tool for screening of NHB, in three non-Caucasian populations in LMICs.
methodsBetween 2018 and 2022, cross-sectional studies were conducted in three countries: Mexico, Nepal and the Philippines. Newborns meeting the inclusion criteria were recruited, and data on demographic characteristics, skin type and visual assessment of jaundice were collected. Bilirubin levels were measured using both the Picterus system and total serum bilirubin (TSB) analysis. Correlation analyses, Bland-Altman plots and receiver operating characteristic (ROC) curves were used to evaluate the Picterus system.
resultsA total of 416 infants were included in the analysis. The Picterus smartphone system demonstrated a significant positive correlation with TSB levels across all sites (r=0.76). The correlation coefficient was significantly higher in Mexico compared with Nepal and the Philippines. Bland-Altman plots showed limits of agreement ±89.2 µmol/L. Picterus values were underestimated in Mexico, whereas they were overestimated in Nepal and the Philippines. ROC analysis for detection of infants with TSB >225 µmol/L indicated that the Picterus system had higher sensitivity and specificity compared with visual assessment using the Kramer scale. DISCUSSION: This study shows that the Picterus system can potentially be used in screening for neonatal jaundice in populations with moderate dark skin types. Further studies are needed before the system can be used in clinical practice.
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