Assessment of screening, treatment and referral facilities of Retinopathy of Prematurity (ROP) among Neonatal Intensive Care Units (NICUs) of Dhaka city through an Orbis supported project

Session Details

Session Title: Orbis Free Paper Session

Session Date/Time: Monday 07/09/2015 | 11:30-12:45

Paper Time: 11:42

Venue: Room 4

First Author: : L.Husain BANGLADESH

Co Author(s): :    L. Husain   F. Islam   S. Akter,   M. Ahmed           

Abstract Details

Purpose:

ROP is emerging as an important avoidable cause of childhood blindness in developing countries. With adequate neonatal services the prevalence of ROP varies from 30-50% in middle-income developing countries. In Bangladesh, the advent of recent developments in neonatal resuscitation services in NICUs increase the rate of survival of premature infants and incidence of ROP. Recognizing the importance of this alarming issue, an assessment of selected NICUs was conducted in Dhaka city by Orbis Bangladesh to assess screening, treatment and referral facilities of ROP with the guidance from Department of Public Health and Informatics of Bangabandhu Sheikh Mujib Medical University, Dhaka

Setting:

As a part of National Childhood Blindness Initiative, Orbis Bangladesh is supporting Ispahani Islamia Eye Institute &Hospital (IIEI&H) to strengthen its ROP services. In order to set a National Guideline and Screening Criteria for ROP, a facility based survey of twelve collaborating NICUs was carried out in Dhaka city.

Methods:

The assessment used a cross-sectional study design. A purposive sample of twelve NICUs, three from government and nine from private sectors, were included in this study. Survey was conducted for two months between 01.12.2013 and 31.01.2014. Both quantitative and qualitative methods were adopted to generate data on the capacity of the proposed NICUs for ROP screening and treatment services. A structured questionnaire was used to collect quantitative data.

Results:

Only 33% of government and 22% of private NICUs have their own ROP screening services without having own trained staff for screening. NICUs those have ROP screening services possess one indirect ophthalmoscope and one +20D/+30 D lens in each facility. None of the surveyed hospital has RetCam for ROP screening. Treatment (Laser) facility for ROP is present in one private facility (11%) only. Clinical protocols are available at 66% of government and 56% of private facilities. Each month an average of six premature low birth weight of 2000 gram and/or <35 weeks are referred for ROP screening from each facility.

Conclusions:

Increased survival of premature low birth weight infants due to advanced neonatal care has resulted in increased incidence of ROP in Bangladesh. However the referral, screening and treatment services for ROP are limited both in government and private hospitals. There is a need for a comprehensive guideline, protocols and training of health professionals related to NICU services for prevention, screening, treatment and follow up of ROP cases with strong referral linkage. Strong cooperation between pediatrician and ophthalmologist as well as sensitization of the policy makers is crucial in the prevention of ROP in Bangladesh.

Financial Interest:

NONE