Early detection of biliary atresia in primary health care: still a problem

Abstract

Background: Biliary atresia is the leading cause of liver transplantation in children. Early detection of biliary atresia is crucial for diagnosis and disease progression. The purpose of this study was to analyze knowledge about biliary atresia and the effectiveness of health education in increasing the knowledge of primary health care providers. Methods:  A quasi-experimental study with pretest and posttest designs was carried out in Sidoarjo, East Java using a self-administered questionnaire. The intervention using health education was delivered by pediatrician and consultant of pediatric gastro hepatology. There were 13 questions on the questionnaire, question numbers 1 to 6 were about normal and abnormal neonatal jaundice, question numbers 7 to 13 were about biliary atresia. Results: A total of 252 participants were involved, the mean age of the participants was 40.7 ± 9.4 years old. Most of the participants were midwives (61.9%) and 77.8% of participants have years of service in primary health care > 5 years.  A total of 40.5% participants stated that newborns may have physiological jaundice, which was characterized by icteric sclera, pale stools, and dark urine. A total of 27,4% and 24,2% participants said that all jaundice in newborn will always improve on their own and newborn with prolonged jaundice does not need further examination, respectively. There was an increase in the median value in the pretest and posttest knowledge scores  after interventional health education (p < 0,05). Conclusions: The primary health care provider understands about biliary atresia, however, the initial knowledge about early detection of biliary atresia is not evenly distributed in all primary health care providers. These findings suggest that improving knowledge to early detection of biliary atresia is needed. Health education can be used effectively in increasing knowledge about biliary atresia.