Diagnostic Accuracy of WHO IMCI Visual Inspection for Neonatal Jaundice: A Prospective Multi-Country Cohort

The study evaluated the accuracy of visual inspection of jaundice according to the World Health Organization algorithm compared to transcutaneous bilirubinometry for identifying hyperbilirubinemia in neonates. The research included 14,331 newborns, of which 1,852 were preterm infants, from six sites in Asia and Africa. At 3-5 days postnatal, hyperbilirubinemia was diagnosed in 15% of infants. Visual inspection showed low sensitivity of 16%, high specificity of 96%, positive percent agreement of 56%, and negative percent agreement of 86%. The poor sensitivity of visual inspection highlights an urgent need for accurate and affordable screening tools to improve hyperbilirubinemia detection in resource-limited settings.