Browsing by Author "Priscillah Koech"

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    Skin Reflectance Changes in Kenyan Neonates during the First Month of Life: An Observational Study
    (Springer Nature, 2025-09) Seth Bokser; Priscillah Koech; Hillary Bosuben; Anne Gaichiumia; Atsushi Miwa; Anthony Wanyoro
    Transcutaneous diagnostic devices are widely used in neonatal care. The American Academy of Pediatrics (AAP) advises universal newborn screening for hyperbilirubinemia, commonly performed with transcutaneous bilirubin (TcB) meters.1 Both the U.S. Centers for Disease Control and AAP recommend universal cyanotic congenital heart disease screening using pulse oximeters.2 Although widely adopted, these transcutaneous devices have faced renewed scrutiny regarding their diagnostic accuracy in patients with darker skin tones, driven by increasing awareness of racial and ethnic disparities in healthcare.3 In vitro studies have demonstrated falsely lower TcB readings with darker modeled skin tones,4 while human population studies have, more often, demonstrated falsely elevated TcB readings in neonates with racial identities associated with darker skin tone.5,6 Other studies have examined biochemical development and color development in lighter skin tone newborns.7 To our knowledge, this is the first study to document developmental changes in skin tone among African newborns with darker skin pigmentation. The U.S. Food and Drug Administration (FDA) and the International Council for Harmonization (ICH) have both emphasized the importance of including diverse patient populations, particularly across different skin tones, in trials assessing transcutaneous diagnostic devices.8,9 Our study can provide these future trials with foundational insights into the optical characteristics of newborn skin correlating not only with skin tone but also developmental age of the pediatrics patient