It’s hard to tell if a baby’s eyes are yellow just by looking at them, but the neoSCB app can tell right away if they need treatment for neonatal jaundice.

A smartphone app that detects severe jaundice in newborn babies just by scanning their eyes could be a lifesaver in locations where expensive screening instruments are unavailable.

Following an initial pilot trial on 37 newborns at University College London Hospital (UCLH) in 2020, clinicians and engineers at UCL developed the app, named neoSCB, which was used to test for jaundice in over 300 newborn babies in Ghana.

The team examined almost 300 babies using the app, which analyzes images taken with a smartphone camera to measure the yellowness of the white area of the eye (sclera) – an indication of neonatal jaundice – for the large-scale study, which was published in Paediatrics.

It’s hard to tell if a baby’s eyes are yellow just by looking at them, but the neoSCB app can tell right away if they need treatment for neonatal jaundice.

The study compared the neoSCB app’s performance to that of traditional screening methods. There were 79 severely jaundiced newborns among the 336 babies examined by the app, and the app accurately recognized 74 of them. This matches the accuracy of the most prevalent conventional screening approach, a non-invasive instrument known as a transcutaneous bilirubinometer, which accurately identified 76 percent of patients.

The transcutaneous bilirubinometer determines jaundice levels by monitoring the yellow pigment under the newborn’s skin. Blood tests are used to follow up on all screening results in order to establish the sort of treatment required.

“The study shows that the neoSCB app is as good as commercial devices currently recommended to screen for severely jaundiced newborns, but the app only requires a smartphone which costs less than a tenth of the commercial device,” says Dr Terence Leung (UCL Medical Physics & Biomedical Engineering), who developed the technology behind the app. “We hope that, once rolled out widely, our technology can be used to save the lives of newborns in parts of the world that lack access to expensive screening devices.”

“The neoSCB method was acceptable to mothers in urban and rural communities where the study was conducted,” adds study leader Dr. Christabel Enweronu-Laryea.

“Mothers easily devised ways to keep the baby’s eye open, most often by initiating breastfeeding.”

Jaundice is a condition in which the skin and whites of the eyes turn yellow and is usually innocuous in neonates. The yellowing is produced by a substance called bilirubin, which can enter the brain and cause death or disabilities like hearing loss, neurological problems like athetoid cerebral palsy, and developmental delays in extreme cases.

Despite being a curable illness, acute jaundice kills 114,000 newborns and causes 178,000 cases of impairment each year around the world. The majority of occurrences of newborn jaundice occur within the first week of life, and in higher-income nations, regular screening for early detection has reduced the risk of serious sequelae.

Most of the time, newborns in low- and middle-income countries are more likely to get severe jaundice, also called neonatal hyperbilirubinemia, because they don’t have the resources to screen for it. A commercial transcutaneous bilirubinometer costs roughly $5,000 per instrument, and blood tests necessitate a lot of storage space. Other factors, such as a higher proportion of home deliveries and early postnatal discharge, may also lead to fewer neonates being screened.

Babies in Sub-Saharan Africa are also at higher risk due to a high frequency of glucose-6-phosphate dehydrogenase (G6PD) deficiency, a hereditary genetic disease linked to an increased risk of haemolysis (when red blood cells break down faster than they are produced) and hyperbilirubinemia.

“This app has the potential to prevent death and disability worldwide in many different settings,” says senior author Dr. Judith Meek (UCLH). “It will reduce unnecessary hospital visits and potentially empower community health workers and parents to care for newborn babies safely.”

Initially, 724 babies between the ages of 0 and 28 days were selected for the study. The 336 people whose data were included in the study had never been treated for jaundice before. The final study excluded babies who were delivered at fewer than 35 weeks, were seriously unwell, or had a very low birth weight. The app was evaluated by frontline healthcare staff and the mothers of the babies, who provided input on its usability.

Image Credit: Getty

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