Filtered-sunlight phototherapy for neonatal jaundice in low-resource settings: evidence for action

Every year, 60–80% of the 134 million babies born worldwide are likely to develop jaundice, with about 18% or 24 million diagnosed with clinically significant hyperbilirubinaemia.1 2 Severe jaundice (typically measuring total serum or plasma bilirubin (TSB) of ≥20 mg/dL or 342 µmol/L)1 is a leading cause of hospitalisation in the first week of life. It accounts for up to 35% of hospital readmissions in the first month of life.3 Severe jaundice is estimated to affect at least 481 000 term or near-term newborns annually, of whom 114 000 die, and more than 63 000 survive with moderate or severe disability.4 The vast majority (over 75%) of the affected infants reside in sub-Saharan Africa and South Asia. This viewpoint examines the potential role of filtered sunlight phototherapy in addressing the burden of neonatal hyperbilirubinaemia in low- and middle-income countries (LMICs) based on evidence from randomised clinical trials.