Table 4

Sensitivity and specificity (as percent), with 95% CIs (in parentheses) of clinical signs of jaundice in neonates aged 1–20 days as assessed by primary healthcare workers for detecting levels of hyperbilirubinaemia

SensitivitySpecificity
DhakaDelhiChandigarhDurbanKumasiLa PazDhakaDelhiChandigarhDurbanKumasiLa Paz
Serum bilirubin > 260 mmol/l (15 mg/dl)
(n=35)*(n=61)(n=38)(n=18)(n=17)(n=103)(n=41)(n=54)(n=294)(n=103)(n=46)(n=78)
Deep jaundice of the head 51 (34 to 69)90 (80 to 96)32 (18 to 49)56 (31 to 78)75 (65 to 83)66 (49 to 80)48 (34 to 62)89 (85 to 92)80 (71 to 87)49 (37 to 60)
Deep jaundice of the runk31(17 to 49)66 (52 to 77)26 (13 to 43)47 (21 to 73)31 (22 to 41)78 (62 to 89)81 (69 to 91)96 (93 to 98)82 (72 to 90)83 (73 to 91)
Any jaundice of the distal extremities66 (48 to 81)64 (51 to 76)55 (38 to 71)56 (31 to 78)88 (64 to 99)42 (32 to 52)66 (49 to 80)80 (66 to 89)89 (85 to 92)56 (46 to 66)76 (61 to 87)71 (59 to 80)
Any jaundice of the distal extremities OR deep jaundice of the trunk66 (48 to 81)77 (65 to 87)58 (41 to 74)67 (41 to 87)44 (34 to 54)66 (49 to 80)72 (58 to 84)88 (84 to 92)49 (39 to 59)69 (58 to 79)
Any jaundice of the distal extremities OR deep jaundice of the head or trunk69 (51 to 83)93 (84 to 98)58 (41 to 74)83 (59 to 96)80 (71 to 87)63 (47 to 78)48 (34 to 62)84 (79 to 88)48 (38 to 58)46 (35 to 58)
Serum bilirubin > 340 mmol/l (20 mg/dl)
(n=14)†(n=25)(n=9)(n=2)‡(n=7)(n=35)(n=62)(n=90)(n=323)(n=119)(n=56)(n=146)
Deep jaundice of the head 79 (49 to 95)96 (80 to 100)67 (30 to 93)94 (81 to 99)66 (53 to 78)34 (25 to 45)88 (84 to 92)76 (67 to 83)42 (34 to 51)
Deep jaundice of the trunk64 (35 to 87)76 (55 to 91)44 (14 to 79)46 (29 to 63)82 (70 to 91)66 (55 to 75)94 (91 to 97)77 (68 to 85)80 (73 to 86)
Any jaundice of the distal extremities93 (66 to 100)80 (59 to 93)89 (52 to 100)100 (59 to 100)57 (39 to 74)61 (48 to 73)67 (56 to 76)86 (81 to 89)55 (45 to 64)66 (52 to 78)68 (60 to 76)
Any jaundice of the distal extremities OR deep jaundice of the head or trunk93 (66 to 100)88 (69 to 97)89 (52 to 100)60 (42 to 76)61 (48 to 73)56 (45 to 66)85 (80 to 89)46 (37 to 56)67 (59 to 75)
Any jaundice of the distal extremities OR deep jaundice of the head or trunk93 (66 to 100)100 (86 to 100)89 (52 to 100)97 (85 to 100)58 (45 to 70)33 (24 to This study had several limitations. We)81 (76 to 85)44 (35 to 53)38 (30 to 47)
  • *Numbers apply to serum bilirubin >260 mmol/L (15 mg/dL) for sites.

  • †Numbers apply to serum bilirubin >340 mmol/L (20 mg/dL) for sites.

  • ‡Both cases were found to have deep jaundice of the face, and one also had jaundice of palms and soles.