Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020.
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Ademola-Popoola Dupe S, Fajolu Iretiola B, Gilbert Clare, Olusanya Bolutife A, Onakpoya Oluwatoyin H, Ezisi Chinyelu N, Musa Kareem O, Chan Robison Vernon Paul, Okeigbemen Valentina W, Muhammad Rilwan C, Malik Aeesha N J, Adio Adedayo O, Bodunde Olubunmi T, Rafindadi Abdulkadir L, Oluleye Tunji S, Tongo Olukemi O, Badmus Sarat A, Adebara Olufunmilayo V, Padhi Tapas Ranjan, Ezenwa Beatrice N, Obajolowo Tokunbo S, Olokoba Lateefat B, Olatunji Victoria A, Babalola Yewande Olubunmi, Ugalahi Mary O, Adenekan Adetunji, Adesiyun Omotayo O, Sahoo Jagdish, Miller Marilyn T, Uhumwangho Odarosa M, Olagbenro Adeduntan S, Adejuyigbe Ebunoluwa A, Ezeaka Chinyere V C, Mokuolu Olugbenga, Ogunlesi Tinuade A, Ogunfowora Olusoga B, Abdulkadir Isa, Abdullahi Fatima L, Fabiyi Abosede T, Hassan Laila H L, Baiyeroju Aderonke M, Opara Peace I, Oladigbolu Kehinde, Eneh Augusta U, Fiebai Bassey E, Mahmud-Ajeigbe Fatima A, Peter Elijah N, Abdullahi Hawwa S
Аннотация
DESIGN: Descriptive case study.
SETTING: Neonatal intensive care units in Nigeria.
PARTICIPANTS: Staff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).
METHODS AND ANALYSIS: A WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017-2018 and to assess challenges in service provision.
RESULTS: In 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.
CONCLUSION: ROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.