Filtered Sunlight Phototherapy to Treat Significant Jaundice: Safety and Efficacy in Neonates

NCT ID: NCT02612727

Last Updated: 2019-07-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 174 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2012-11-30
• Study Completion Date: 2013-09-30

Brief Summary

At present, much of sub-Saharan Africa, including Nigeria and other resource-limited countries, are without ready access to CPT, due to factors including the lack of PT devices, which are expensive and require consistent electric power to operate. NHB is a significant cause of neonatal morbidity and mortality, but preventable when appropriate treatment is initiated. We have shown that FS-PT is safe and efficacious for the treatment of mild-moderate NHB. The major goal of this study is to demonstrate that FS-PT is efficacious for the treatment of significant/severe NHB, generally defined as TB of ≥12-14mg/dL (but more specially as defined as needing phototherapy per American Academy of Pediatric 2004 guidelines). This arm was done at 1 site in Nigeria (in Ogbomoso). The rationale for conducting the study is that in Nigeria, and other countries that cannot afford effective commercial light devices and/or have no reliable electric power to operate them, filtered sunlight phototherapy might offer a safe and effective treatment for neonatal jaundice.

Detailed Description

Severe neonatal hyperbilirubinemia (NHB) and its progression to kernicterus is a leading cause of deaths and disabilities among newborns in the developing world, particularly in sub-Saharan Africa including Nigeria. Many infants live in villages/towns far from clinical facilities capable of providing conventional artificial blue light phototherapy (CPT) which is the standard treatment for NHB in the industrialized world. Hence, more babies succumb to this preventable tragedy principally on account of lack of electricity and/or available/affordable CPT.

To make treatment of NHB more readily available, we designed and tested a novel, yet simple, practical alternative device to deliver blue light PT in underserved areas from filtered sunlight. The investigators pilot study demonstrated that appropriately filtered sunlight phototherapy (FS-PT) not only offers safe and affordable treatment for infants with mild-moderate NHB, but is also no less efficacious than CPT. Other studies have shown faster decline at higher bilirubin (TB) levels and with higher irradiances. The next logical step to move this urgently needed and exciting therapy forward is to test FS-PT in infants with significant/severe NHB as defined by the American Academy of Pediatrics (AAP) criteria for high-risk infants. In doing so, the investigators will potentially be preventing acute bilirubin encephalopathy (ABE) and kernicterus in many of these infants.

Conditions

Jaundice, Neonatal

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Filtered-sunlight phototherapy

Infants will receive \>= four hours per day of filtered-sunlight phototherapy for 1 to 10 days. The filtering will be done using Air Blue 80 window tinting film.

Group Type: EXPERIMENTAL

Filtered-sunlight phototherapy

Intervention Type: DEVICE

Infants will receive \>= four hours per day of filtered-sunlight phototherapy for 1 to 10 days. The filtering will be done using Air Blue 80 window tinting film.

Intensive phototherapy

Infants will receive \>= four hours per day of intensive phototherapy for 1 to 10 days.

Group Type: ACTIVE_COMPARATOR

Intensive phototherapy

Intervention Type: DEVICE

Infants will receive \>= four hours per day of intensive phototherapy for 1 to 10 days.

Interventions

Filtered-sunlight phototherapy

Infants will receive \>= four hours per day of filtered-sunlight phototherapy for 1 to 10 days. The filtering will be done using Air Blue 80 window tinting film.

Intervention Type: DEVICE

Intensive phototherapy

Infants will receive \>= four hours per day of intensive phototherapy for 1 to 10 days.

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Subjects will be eligible to participate in the study if all of the following conditions exist:

1. At time of birth, infant is > 35 weeks gestation (or ≥ 2.2 kg if gestational age is not available.

2. Infant is < 14 days old at the time of enrollment.

3. Infant has an elevated TB defined as at the level recommended for high-risk infants per AAP guidelines or higher.

4. Parent or guardian has given consent for the infant to participate.

Exclusion Criteria

• Subjects will be excluded from enrollment in the study if any of the following conditions exist:

1. Infants with a condition requiring referral for treatment not available at the hospital study site.

2. Infants with a life-expectancy of < 24 hours at screening enrollment.

3. Infants requiring oxygen therapy unless that can be provided while under PT.

4. Infants clinically dehydrated or sunburned at the time of screening enrollment.

5. Infants with a temperature < 36.0 or > 37.5 degrees Centigrade that does not return to normothermia within 1 hour.

• Maximum Eligible Age: 14 Days
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Thrasher Research Fund

OTHER

Sponsor Role: collaborator

University of Minnesota

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Tina M Slusher

Role: PRINCIPAL_INVESTIGATOR

University of Minnesota

Locations

Bowen University Teaching Hospital

Ogbomoso, , Nigeria

Countries

Nigeria

References

Olusanya BO, Omololu OM, Osamebor FB, Olufosoye A, Alo T, Olaifa SM, Emokpae AA, Olusanya JO, Mabogunje CA. Filtered-sunlight phototherapy for newborns with moderate-to-severe hyperbilirubinemia: a randomized trial. Pediatr Res. 2025 Jun 28. doi: 10.1038/s41390-025-04207-6. Online ahead of print.

Reference Type: DERIVED

PMID: 40581699 (View on PubMed)

Olusanya BO, Emokpae AA, Aina OA, Imam ZO, Olaifa SM, Owolabi OB, Osamebor FB, Olufosoye A, Alo T, Osadolor A Jr, Olusanya JO, Mabogunje CA. Heliotherapy for neonates with severe-to-hazardous hyperbilirubinemia: a randomized controlled, non-inferiority trial. Sci Rep. 2024 Oct 27;14(1):25646. doi: 10.1038/s41598-024-77085-3.

Reference Type: DERIVED

PMID: 39465350 (View on PubMed)

Other Identifiers

1108M03601_Phase 2

Identifier Type: -

Identifier Source: org_study_id