Current management of retinopathy of prematurity in sub-Saharan Africa

Lloyd, Trevor; Isenberg, Sherwin J.; Lambert, Scott R.

doi:10.1016/j.jaapos.2020.03.002

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Despite these limitations, this study includes more countries than any other study on oxygen management in neonatal care units in sub-Saharan Africa to the best of our knowledge. Other studies did not have as many countries represented [13], were Fig. 1 Neonatal care units in sub-Saharan Africa who responded to our survey.…”

Section: Discussionmentioning

confidence: 98%

“…Ophthalmologists in Africa only have limited access to laser photocoagulation [13], the current standard of care for treatment of severe ROP. Even if laser treatment was readily available in every neonatal unit, many units in sub-Saharan Africa report a high number of infants lost to follow-up [28,29], which would reduce its effectiveness.…”

Section: Discussionmentioning

confidence: 99%

“…Even if laser treatment was readily available in every neonatal unit, many units in sub-Saharan Africa report a high number of infants lost to follow-up [28,29], which would reduce its effectiveness. Anti-VEGF medication is the most common treatment modality for ROP in sub-Saharan Africa [13], but the recurrence rate is high [30]. This suggests that infants may still become blind despite receiving treatment due to the recurrence of ROP following discharge.…”

Section: Discussionmentioning

confidence: 99%

“…Recent reports indicate that units in sub-Saharan Africa have high patient to nurse ratios [11,12] likely making oxygen saturation monitoring difficult. Previously, we reported on the management of ROP in preterm infants in sub-Saharan Africa [13]. Responses from 28 neonatologists from 8 sub-Saharan Africa countries revealed that 64% did not have the capacity to reduce supplemental oxygen concentration by blending oxygen with air.…”

Section: Introductionmentioning

confidence: 97%

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Oxygen management among infants in neonatal units in sub-Saharan Africa: a cross-sectional survey

et al. 2021

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Objectives To provide more comprehensive data on the management of oxygen supplementation in neonates in sub-Saharan Africa.Study design An online survey on the management of oxygen supplementation for infants in neonatal units was sent to 278 healthcare personnel in sub-Saharan Africa.Results One hundred and nine responses from 82 neonatal care units in 54% (26/48) sub-Saharan African countries were received. All units had the capacity to provide oxygen supplementation. However, only 50% (38/76) had access to blend oxygen with medical air and 1% (1/75) had the capacity to blend oxygen/air for every infant. Although 96% (72/75) of units could monitor oxygen saturation, monitoring was mostly intermittent and only 32% (24/75) were able to monitor oxygen saturation in every infant receiving oxygen supplementation. Conclusions Findings indicate that oxygen supplementation is inadequately managed in neonatal units in sub-Saharan Africa, which may put infants at risk of developing severe ROP.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Oxygen management among infants in neonatal units in sub-Saharan Africa: a cross-sectional survey

et al. 2021

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“…These interventions are indeed not always present in a rural context, and so this would make it difficult to extrapolate to less-resourced units. In a survey of current oxygen management, screening criteria, and methods for treating ROP in sub-Saharan Africa, this unit is in a better-resourced position compared to the median of 3.5 oxygen measurement devices and 0 oxygen blenders and maximums of 70 and 50, respectively ( 25 ). These efforts in reducing the risk factors have resulted in a reduction in the rates of ROP in our population.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Retinopathy of Prematurity Using the WINROP (Weight, IGF-1, Neonatal Retinopathy of Prematurity) Algorithm in a South African Population

Kesting

Nakwa

2022

Front. Pediatr.

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AimThis study aimed to assess the efficacy of the WINROP (Weight, IGF-1, Neonatal Retinopathy of Prematurity) screening algorithm in a South African population.MethodsA retrospective record review included infants born between 1 January 2013 and 1 December 2014 who underwent ROP (retinopathy of prematurity) screening. Outcomes of ophthalmology examinations were compared to alarms triggered on WINROP after gestational age, date of birth, and weekly weights were entered. Sensitivity, specificity, positive predictive, and negative predictive values and mean time of alarm were calculated.ResultsRates of ROP were 5.9% for all stages of ROP and 2.3% for severe ROP in the 220 infants included. Mean gestation age was 29.1 ± 1.3 weeks and mean birth weight 1,115.5 ± 201 g. WINROP triggered high-risk alarms in 70.5% of infants at a mean of 30.7 weeks of gestational age. Sensitivity for severe ROP was 100 and 76.9% for all stages of ROP. Specificity was low for both severe ROP and all stages of ROP at 30.2 and 30.0%, respectively.ConclusionRates of ROP are low in this population. The high number of alarms with a low negative predictive value would reduce the number of screens by 29.5%. Alarms were triggered before scheduled screening, possibly helpful in planning discharges and follow-up visits.

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