title: Care practices and traditional beliefs related to neonatal jaundice in northern Vietnam: a population-based, cross-sectional descriptive study.
abstract: BACKGROUND
  The National Hospital of Pediatrics in Vietnam performed >200 exchange transfusions annually (2006-08), often on infants presenting encephalopathic from lower-level hospitals. As factors delaying care-seeking are not known, we sought to study care practices and traditional beliefs relating to neonatal jaundice in northern Vietnam.
  
  
  METHODS
  We conducted a prospective, cross-sectional, population-based, descriptive study from November 2008 through February 2010. We prospectively identified mothers of newborns through an on-going regional cohort study. Trained research assistants administered a 78-item questionnaire to mothers during home visits 14-28 days after birth except those we could not contact or whose babies remained hospitalized at 28 days.
  
  
  RESULTS
  We enrolled 979 mothers; 99% delivered at a health facility. Infants were discharged at a median age of 1.35 days. Only 11% received jaundice education; only 27% thought jaundice could be harmful. During the first week, 77% of newborns were kept in dark rooms. Only 2.5% had routine follow-up before 14 days. Among 118 mothers who were worried by their infant's jaundice but did not seek care, 40% held non-medical beliefs about its cause or used traditional therapies instead of seeking care. Phototherapy was uncommon: 6 (0.6%) were treated before discharge and 3 (0.3%) on readmission. However, there were no exchange transfusions, kernicterus cases, or deaths.
  
  
  CONCLUSIONS
  Early discharge without follow-up, low maternal knowledge, cultural practices, and use of traditional treatments may limit or delay detection or care-seeking for jaundice. However, in spite of the high prevalence of these practices and the low frequency of treatment, no bad outcomes were seen in this study of nearly 1,000 newborns.
authors.affiliation: Department of Pediatrics, University of California, San Francisco, Box 0748, 533 Parnassus Ave, U585, San Francisco, CA 94143, USA. loctle@gmail.com.
authors.forename: Loc T
authors.initials: LT
authors.lastname: Le
authors.forename: John Colin
authors.initials: JC
authors.lastname: Partridge
authors.forename: Bich H
authors.initials: BH
authors.lastname: Tran
authors.forename: Vui T
authors.initials: VT
authors.lastname: Le
authors.forename: Tuan K
authors.initials: TK
authors.lastname: Duong
authors.forename: Ha T
authors.initials: HT
authors.lastname: Nguyen
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Newman
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005078:Exchange Transfusion, Whole Blood / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000628:therapy*; D008519:Medicine, Traditional / Q000706:statistics & numerical data; D010290:Parents; D010351:Patient Discharge; D010353:Patient Education as Topic; D010789:Phototherapy / Q000706:statistics & numerical data; D008517:Phytotherapy / Q000706:statistics & numerical data; D011446:Prospective Studies; D014744:Vietnam