Retinopathy of prematurity in Rwanda: a prospective multi-centre study following introduction of screening and

Francis Mutangana1, Charles Muhizi2, Godelieve Mudereva3

  • 1Ophthalmology, King Faisal Hospital, Kigali, Rwanda.

Eye (London, England)
|August 1, 2019
PubMed

Insights

Risk factors for retinopathy of prematurity (ROP) in Rwanda include prolonged oxygen use and hyperglycemia. These findings highlight the need for improved neonatal care and adjusted screening guidelines to address this emerging health issue.

Area of Science:

  • Neonatal ophthalmology
  • Public health
  • Perinatal medicine

Background:

  • Retinopathy of prematurity (ROP) is a significant cause of visual impairment in premature infants.
  • Established ROP screening programs are crucial for early detection and intervention.
  • The epidemiology and risk factors for ROP in African populations require further investigation.

Purpose of the Study:

  • To identify risk factors associated with retinopathy of prematurity (ROP) in a newly established screening and management program in Rwanda.
  • To evaluate the incidence of ROP and treatment-warranted ROP within this specific population.
  • To inform the development of targeted interventions and improved neonatal care practices.

Main Methods:

  • A multi-center prospective study involving 795 eligible infants (gestational age < 35 weeks or birth weight < 1800g).
  • ROP screening was conducted on 424 infants, with classification based on the revised International Classification of ROP (2005).
  • Maternal and perinatal risk factors were collected from neonatal records, with univariate and multivariate analyses performed.

Main Results:

  • Any ROP developed in 7.3% of screened infants, with 41.9% requiring treatment.
  • Significant risk factors identified in univariate analysis included increased supplemental oxygen duration, low gestational age, low birth weight, hyperglycemia, blood transfusion, and sepsis.
  • Multivariate analysis confirmed longer exposure to supplemental oxygen and hyperglycemia as significant independent risk factors for ROP.

Conclusions:

  • Retinopathy of prematurity (ROP) is an emerging health concern in Rwanda, necessitating dedicated screening and treatment programs.
  • Current ROP screening guidelines may need to be adapted for the Rwandan context, potentially screening infants beyond the 2013 American Academy guidelines.
  • Enhancing the quality of neonatal care, particularly in oxygen administration and monitoring, is critical to reduce the incidence and severity of ROP.
Abstract

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