Article Sidebar

Submitted
7 August 2023
Accepted
23 March 2024
Published
10 March 2024
Download
PDF
Statistic
Read Counter : 107 Download : 64

Main Article Content

Abstract

Highlights:
1. An evaluation is necessary to verify that the knowledge of healthcare providers is sufficient for the early detection of biliary atresia.
2. It is crucial to promote education on prolonged jaundice to ensure early detection of biliary atresia in primary health facilities, as some primary healthcare providers have insufficient knowledge on the subject.


 


Abstract
Primary healthcare providers frequently fail to recognize biliary atresia because it closely mimics physiological jaundice. Early detection plays an important role in ensuring the optimal treatment of biliary atresia. Delays in referring to biliary atresia cases remain a problem around the world. The objective of this study was to analyze the knowledge of primary healthcare providers regarding prolonged jaundice as an early sign of biliary atresia. A cross-sectional study was conducted at primary healthcare centers using a self-administered questionnaire. The data were analyzed descriptively with the assistance of IBM SPSS Statistics for Windows, version 21.0 (IBM Corp., Armonk, N.Y., USA). A total of 271 respondents participated in this study, including midwives (63.8%), nurses (24.4%), and medical doctors (8.5%). This study found that 73.8% of the respondents agreed that infants with prolonged jaundice need to undergo a serum bilirubin level assessment. However, 40.2% of the respondents believed that pale stools and dark urine in yellow infants were symptoms of physiological jaundice. Concerning the definition of prolonged jaundice, 209 (77.1%) respondents provided a response indicating more than two weeks. A total of 137 (50.6%) respondents stated that biliary atresia is a disease that must be ruled out first in cases of prolonged jaundice. Nevertheless, 86 (31.7%) and 87 (32.1%) respondents also mentioned that breastfeeding jaundice and breast milk jaundice must be considered as potential causes to be investigated. These results indicated that primary healthcare providers still had limited knowledge regarding cholestasis. Education on prolonged jaundice in primary healthcare centers should be more improved to enhance the early detection of biliary atresia.


 

Keywords

Biliary atresia primary healthcare provider education early detection child mortality

Article Details

License

Copyright (c) 2024 Folia Medica Indonesiana

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Rendi Aji Prihaningtyas, Bagus Setyoboedi, Ni Nyoman Metriani Nesa, Melinda Masturina, Martono Tri Utomo, & Sjamsul Arief. (2024). Primary Healthcare Providers’ Knowledge on the Early Detection of Biliary Atresia. Folia Medica Indonesiana, 60(1), 85–93. https://doi.org/10.20473/fmi.v60i1.48446
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Al-Hussaini A, Abanemai M, Alhebbi H, et al (2022). The epidemiology and outcome of biliary atresia: Saudi Arabian national study (2000–2018). Frontiers in Pediatrics. doi: 10.3389/fped. 2022.921948.
  2. Antala S, Taylor SA (2022). Biliary atresia in children. Clinics in Liver Disease 26, 341–354. doi: 10.1016/j.cld.2022.03.001
  3. Apfeld JC, Cooper JN, Sebastií£o Y V, et al (2021). Variability in age at Kasai portoenterostomy for biliary atresia across US children's hospitals. Journal of Pediatric Surgery 56, 1196–1202. doi: 10.1016/j.jpedsurg.2021.02.027.
  4. Asai A, Miethke A, Bezerra JA (2015). Pathogenesis of biliary atresia: defining biology to understand clinical phenotypes. Nature Reviews Gastroenterology & Hepatology12, 342–352. doi: 10.1038/nrgastro.2015.74.
  5. Cavallo L, Kovar EM, Aqul A, et al (2022). The epidemiology of biliary atresia: Exploring the role of developmental factors on birth prevalence. The Journal of Pediatrics 246, 89-94. doi: 10.1016/j.jpeds.2022.03.038.
  6. Davenport M, Kronfli R, Makin E (2023). Advances in understanding of biliary atresia pathogenesis and progression – a riddle wrapped in a mystery inside an enigma. Expert Review of Gastroenterology & Hepatology17, 343–352. doi: 10.1080/17474124.2023.2191188.
  7. Dehghani SM, Efazati N, Shahramian I, et al (2015). Evaluation of cholestasis in Iranian infants less than three months of age. Gastroenterology and Hepatology from Bed to Bench 8, 42-48. Available at: http://www.pubmedcentral.nih.gov/ articlerender.fcgi?artid=PMC4285931.
  8. Fawaz R, Baumann U, Ekong U, et al (2017). Guideline for the evaluation of cholestatic jaundice in infants. Journal of Pediatric Gastroenterology and Nutrition 64, 154–168. doi: 10.1097/MPG.0000000000001334.
  9. Goodhue C, Fenlon M, Wang KS (2017). Newborn screening for biliary atresia in the United States. Pediatric Surgery International 33, 1315–1318. doi: 10.1007/s00383-017-4159-3.
  10. Gu YH, Yokoyama K, Mizuta K, et al (2015). Stool color card screening for early detection of biliary atresia and long-term native liver survival: A 19-year cohort study in Japan. The Journal of Pediatrics 166, 897-902. doi: 10.1016/j.jpeds.2014 .12.063.
  11. Gu Y, Matsui A (2017). Long"term native liver survival in infants with biliary atresia and use of a stool color card: Case–control study. Pediatrics International 59, 1189–1193. doi: 10.1111/ped.13 360.
  12. Harpavat S, Lupo PJ, Liwanag L, et al (2018). Factors influencing time"to"diagnosis of biliary atresia. Journal of Pediatric Gastroenterology and Nutrition 66, 850–856. doi: 10.1097/MPG.000000 0000001887.
  13. Hodgson JM, van Someren VH, Smith C, et al (2018). Direct bilirubin levels observed in prolonged neonatal jaundice: a retrospective cohort study. BMJ Paediatrics Open 2, e000202. doi: 10.1136/bmjpo-2017-000202.
  14. Holdar S, Alsaleem B, Asery A, et al (2019). Outcome of biliary atresia among Saudi children: A tertiary care center experience. Saudi Journal of Gastroenterology 25, 176. doi: 10.4103/sjg.SJG_ 306_18.
  15. Hopkins PC, Yazigi N, Nylund CM (2017). Incidence of biliary atresia and timing of hepatoportoenterostomy in the United States. The Journal of Pediatrics 187, 253–257. doi: 10.1016/j. jpeds.2017.05.006.
  16. IBM Corp (2012). IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp. Available at: https://www.ibm.com/id-id/products /spss-statistics.
  17. Isa HM, Irshad Z (2023). Clinical characteristics and outcome of infants with biliary atresia in Bahrain. Oman Medical Journal 38, 485–485. doi: 10.5001/omj.2023.64.
  18. Jimenez"Rivera C, Jolin"Dahel KS, Fortinsky KJ, et al (2013). International incidence and outcomes of biliary atresia. Journal of Pediatric Gastro enterology and Nutrition 56, 344–354. doi: 10.1097/MPG.0b013e318282a913.
  19. Khayat A, Alamri AM, Saadah OI (2021). Outcomes of late Kasai portoenterostomy in biliary atresia: a single-center experience. Journal of International Medical Research 49. doi: 10.1177/03000605211012596.
  20. Lee M, Chen SCC, Yang HY, et al (2016). Infant stool color card screening helps reduce the hospitalization rate and mortality of biliary atresia. Medicine (Baltimore) 95, 3166. doi: 10.1097/MD. 0000000000003166.
  21. Lien TH, Chang MH, Wu JF, et al (2011). Effects of the infant stool color card screening program on 5-year outcome of biliary atresia in taiwan. Hepatology 53, 202–208. doi: 10.1002/hep.24023.
  22. Lin JS (2015). Reduction of the ages at diagnosis and operation of biliary atresia in Taiwan: A 15-year population-based cohort study. World Journal of Gastroenterology 21, 13080. doi: 10.3748/wjg. v21.i46.13080.
  23. Liu MB, Huong TB, Hoang X, et al (2017). Biliary atresia in Vietnam: Management and the burden of disease. Surgery 161, 533–537. doi: 10.1016/j.sur g.2016.08.012.
  24. Maisels MJ, Clune S, Coleman K, et al (2014). The natural history of jaundice in predominantly breastfed infants. Pediatrics 134, 340–345. doi: 10.1542/peds.2013-4299.
  25. Matsui A (2017). Screening for biliary atresia. Pediatric Surgery International 33, 1305–1313. doi: 10.1007/s00383-017-4175-3.
  26. Menz TJ, Herzlinger M, Ross A, et al (2019). Knowledge, attitudes, and behaviors of pediatric primary care providers on management of cholestasis. Global Pediatric Health 6. doi: 10.1177/2333794X19829757.
  27. Mitra S, Rennie J (2017). Neonatal jaundice: aetiology, diagnosis and treatment. British Journal of Hospital Medicine 78, 699–704. doi: 10.12968/ hmed.2017.78.12.699.
  28. Qisthi SA, Saragih DSP, Sutowo DW, et al (2020). Prognostic factors for survival of patients with biliary atresia following kasai surgery. The Kobe journal of medical sciences 66, 56–60. Available at: http://www.pubmedcentral.nih.gov/articlerend er.fcgi?artid=PMC7837656.
  29. Setyoboedi B, Prihaningtyas RA, Utomo MT, et al (2022a). Early detection of biliary atresia in primary health care: still a problem. F1000Research 11, 1245. doi: 10.12688/f1000rese arch.125555.1.
  30. Setyoboedi B, Utomo MT, Prihaningtyas RA, et al (2022b). Level of knowledge of bilier atresia in midwife in Puskesmas, Sidoarjo District. Jurnal Abdi Insani 9, 1839–1846. doi: 10.29303/abdiinsa ni.v9i4.813.
  31. Tan HS, Balasubramaniam IS, Amar-Singh HSS, et al (2019). Impact of a standardized protocol for the management of prolonged neonatal jaundice in a regional setting: an interventional quasi-experimental study. BMC Pediatr 19, 174. doi: 10.1186/s12887-019-1550-3.
  32. Townsend MR, Jaber A, Abi Nader H, et al (2018). Factors associated with timing and adverse outcomes in patients with biliary atresia undergoing kasai hepatoportoenterostomy. The Journal of Pediatrics 199, 237-242. doi: 10.1016/j.jpeds.2018.04.001.
  33. Wang Z, Chen Y, Peng C, et al (2019). Five-year native liver survival analysis in biliary atresia from a single large Chinese center: The death/liver transplantation hazard change and the importance of rapid early clearance of jaundice. Journal of Pediatric Surgery 54, 1680–1685. doi: 10.1016/j.jpedsurg.2018.09.025.

Most read articles by the same author(s)