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A novel, low-cost method of enrolling infants at risk for Retinopathy of Prematurity in centers with no screening
Anand Vinekar1, Kavitha Avadhani, Mangat Dogra
1Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore, India. anandvinekar@yahoo.com
Insights
The Red Card for Retinopathy of Prematurity (REDROP) study shows a low-cost method effectively enrolls infants into screening programs. This strategy, costing less than US$0.10 per infant, can improve access to essential retinopathy of prematurity care.
Area of Science:
- Ophthalmology
- Neonatal Care
- Public Health
Background:
- Retinopathy of prematurity (ROP) is a leading cause of childhood blindness.
- Limited expertise in ROP screening exists in many healthcare settings.
- Effective, low-cost enrollment strategies are crucial for underserved populations.
Purpose of the Study:
- To evaluate the first-year outcomes of the Red Card for Retinopathy of Prematurity (REDROP) study.
- To assess a novel, low-cost interim strategy for ROP screening enrollment.
- To pilot the REDROP strategy in a multi-specialty general hospital setting.
Main Methods:
- A red card system was implemented in the neonatal unit for infants weighing ≤ 2000 g.
- Red cards provided tri-lingual information on ROP and screening venue.
- Mothers were contacted via phone, and screening/treatment were free.
Main Results:
- 27.8% of infants weighed ≤ 2000 g; 75.4% of these were eligible for the red card.
- 53.8% of eligible infants received a red card; 47.3% completed ROP screening.
- 32.6% of screened infants had ROP, with 6.9% requiring laser treatment. Inability to contact mothers was a key barrier.
Conclusions:
- The REDROP strategy is a feasible, low-cost method for enrolling infants into ROP programs.
- The cost per enrolled infant was less than US$0.10.
- Further multi-center validation is recommended to improve enrollment strategies.
Purpose:
To report the first-year results of the Red Card for Retinopathy of Prematurity (REDROP) study, a low-cost interim strategy to enroll infants into retinopathy of prematurity (ROP) screening where limited expertise exists, piloted at a multi-specialty general hospital.
Methods:
Red "warning" cards were placed alongside green "congratulations" cards above the weighing scale in the neonatal unit. Staff weighing the newborn were instructed to give either one of the cards to each mother depending on the weight of the child (≤ 2000 g, red, and > 2000 g, green). Red cards contained information (tri-lingual) about ROP and the venue of screening. Green cards contained general pediatric eye education and recipients were not called. A portion of the red card with the infant's birth date and mother's contact number was retained and collected weekly by volunteers. Mothers were reminded on the mobile phone to come for ROP screening. Screening and treatment were performed free.
Results:
During the study period, 224 of 805 (27.8%) infants were born ≤ 2000 g. Of these, 169 (75.4%) survived and were eligible for the red card; 91 (53.8%) received it. Of these, 43 (47.3%) infants completed ROP screening, 14 (32.6%) had some stage ROP, and three (6.9%) required laser treatment. The main reason for the lower turnout for screening was the inability to contact mothers on their provided phone numbers.
Conclusions:
REDROP demonstrates the feasibility of this low-cost method of enrolling unscreened infants into a ROP program. The cost of enrolling each infant was less than 5 rupees (US$0.10). Suggested strategies to improve use require multi-center validation.
