Ward design and neonatal jaundice in the tropics: Report of an epidemic

Abstract

Architectural modifications to an existing tropical obstetric ward involved extension of the roof overhangs to a width of several metres. These extensions excluded most of the daylight from the ward. An alarming increase in the incidence of jaundice (bilirubin concentration ≥240 fimol/1 (≥14 mg/100 ml)) from 0.5% to 17% in newborn infants occurred after the modifications. Tropical obstetric wards and nurseries should continue to be built with windows facing north-south for coolness. They should, however, have as many windows as possible and the roof overhangs should be limited to about 1 m to allow adequate indirect sunlight to enter, giving a high intensity of illumination, and help prevent neonatal jaundice. © 1985, British Medical Journal Publishing Group. All rights reserved.