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. 2021 Jul 6;2021(7):CD013277. doi: 10.1002/14651858.CD013277.pub2
Study Reason for exclusion
Emokpae 2016 Emokpae and colleagues reviewed medical records of infants admitted for neonatal hyperbilirubinemia in an inner‐city Children's Hospital in Lagos, Nigeria, between January 2012 and December 2014 to determine the pattern, treatment, and outcomes for these infants during the preintervention period prior to the start of enrollment for Slusher 2015. Factors associated with adverse outcomes were identified through multivariable logistic regression. This was not an RCT evaluating sunlight for hyperbilirubinemia.
Olusanya 2014 Cross‐sectional satisfaction survey conducted among mothers of jaundiced infants treated with FSPT in an inner‐city maternity hospital in Lagos, Nigeria from November 2013 to March 2014. Mothers' experience during treatment was elicited with a pretested questionnaire consisting of closed and open‐ended items. Satisfaction was rated on a 5‐point Likert scale. Correlates of overall maternal satisfaction were explored with descriptive and inferential non‐parametric statistics.
191 mothers were surveyed, 77 (40%) of whom had no prior knowledge of neonatal jaundice. Maternal satisfaction was highest for quality of nursing care received (mean 4.72, SD 0.55; median 5, IQR 5 to 5) and lowest for physical state of the test environment (mean 3.85, SD 0.74, median 4, IQR 3 to 4). The overall rating (mean 4.17, SD 0.58; median 4, IQR 4 to 5) and the observed effect of FSPT on the infants (mean 4.34, SD 0.58; median 4, IQR 4 to 5) were satisfactory. FSPT experience was significantly correlated with the adequacy of information received (P < 0.0005), test environment (P = 0.002), and the observed effect of FSPT on the child (P < 0.0005). 98.4% of mothers indicated willingness to use FSPT in future or recommend it to others, although some (30 [15.7%]) disliked the idea of exposing newborns to sunlight. This was not an RCT evaluating sunlight for hyperbilirubinemia.
Slusher 2014 Pilot study prior to the RCT conducted in Slusher 2015. Slusher and colleagues evaluated safety and efficacy of FSPT in term/late preterm infants ≤ 14 days old with clinically significant jaundice, assessed by TB levels. Infants were recruited from a maternity hospital in Lagos, Nigeria. Sunlight was filtered with commercial window‐tinting films that removed most UV and significant levels of IR light and transmitted effective levels of therapeutic blue light. After placing infants under an FSPT canopy, hourly measurements of axillary temperatures, monitoring for sunburn, dehydration, and irradiances of filtered sunlight were performed. Treatment was deemed safe and efficacious if infants were able to stay in FSPT for ≥ 5 hours and rate of rise of TB was < 0.2 mg/dL/hour for infants ≤ 72 hours of age or TB decreased for infants > 72 hours of age. 227 infants received 258 days of FSPT.
Vreman 2013 Vreman and colleagues evaluated 9 semi‐transparent plastic window‐tinting films for their ability to block UVA and IR radiation and transmit therapeutic blue light (400–520 nm) for treating jaundiced newborns. For indoor testing, 3 light sources (TL/52 special blue fluorescent, Black Light UVA, and IR heat lamps) were positioned above each film and measured successively using a thermocouple thermometer, UVA radiometer, and blue light irradiance meter, placed below each film. For outdoor testing, the same setup was used with the sun at zenith and a cloudless sky. Compared with unfiltered radiation, blue light transmission through films ranged was 24–83%, UVA transmission was 0.1–7.1%, and reductions in IR heat were 6–12 °C for the heat lamp and 5–10 °C for the sun. Data suggested that most of the relatively low‐cost window‐tinting films tested can effectively reduce sunlight UV and IR and offer a range of significant attenuations of therapeutic blue light. This was not an RCT evaluating sunlight for the treatment of hyperbilirubinemia.

FSPT: filtered‐sunlight phototherapy; IQR: interquartile range; IR: infrared; RCT: randomized controlled trial; SD: standard deviation; TB: total bilirubin; UV: ultraviolet; UVA: ultraviolet A.