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TitleRetinopathy of Prematurity in Rwanda: setting up a screening system.
PurposeTo investigate risk factors for retinopathy of prematurity (ROP) in Rwanda, Africa.
MethodsAll preterm neonates admitted to three tertiary neonatal intensive care units (NICU) who met inclusion criteria (gestational age (GA) <35 weeks or birth weight (BW) <1800 grams) were recruited from September 2015 to July 2017. Data on maternal and perinatal risk factors were collected from the daily neonatal progress notes.
Results795/2222 (36%) babies fulfilled the inclusion criteria on admission, 424 (53%) of whom were screened for ROP. 31 babies (7.3%, CI 5.0-10.2) developed any ROP, 13 (3.1%, CI 1.6-5.2) of whom required treatment. ROP was seen in 6 neonates with GA >30 weeks and BW >1500 grams, 1 of whom required treatment. In univariate analysis the following were associated with any ROP: increasing number of days on supplemental oxygen (OR 2.1, CI 1.5-3.0, P<0.001), low GA (OR 3.4, CI 1.8-6.4, P<0.001), low BW (OR 2.3, CI 1.5-3.4, P<0.001), at least one episode of hyperglycemia ≥150mg/dl (OR 6.6, CI 2.0-21.5, P<0.001), blood transfusion (OR 3.5, CI 1.6-7.4, P<0.001) or sepsis (OR 3.2, CI 1.2-8.6, P=0.01). In multivariate analysis longer exposure to supplemental oxygen (OR 2.1, CI 1.12-3.6, P=0.01) and hyperglycemia (OR 3.5, CI 1.0-12.4, P=0.05) remained significant.
ConclusionThis study adds to the evidence of the need to programs for ROP in sub-Saharan Africa. ROP screening is indicated beyond the 2013 American Academy screening guidelines. Improved quality of neonatal care, particularly oxygen delivery is needed. Further sensitization of parents and health professionals is important to reduce loss to follow-up.
Conflict of interestNo
Authors 1
Last nameDE SMEDT
DepartmentAZ St Maarten
Authors 2
Last nameMudereva
DepartmentUniversity Teaching Hospital of Kigali (CHUK)
CityKigali, Rwanda
Authors 3
Last nameCasteels
DepartmentOphthalmology department, KU Leuven
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