Third, the reasons why some cases of hyperbilirubinemia led to ET are unknown because medical examinations are limited in Myanmar; routine examinations are limited to G6PD screening and ABO/Rh incompatibility, and do not include blood complete picture, bleeding and clotting profiles, cerebral hemorrhage, metabolic diseases, abnormalities on thyroid gland, or scrutiny on infection. Here, G6PD is linked to Other metabolic disease.