Retinopathy of prematurity in Kenya: prevalence and risk factors in a hospital with advanced neonatal care

Abstract

IntroductionIncreased survival of preterm babies in sub-saharan Africa has held to an increasing prevalence of Retinopathy of prematurity (ROP). This study was done to determine the ROP prevalence in a hospital with advanced neonatal care in urban Kenya.MethodsA hospital-based retrospective review of the records of premature infants screened for ROP between January 2010 and December 2015. Records of all premature infants screened for ROP in the neonatal unit and outpatient eye clinic were extracted. Information on Birth weights, Gestational age, Maternal risk factors (mode of delivery, pre-eclampsia/eclampsia) and Neonatal risk factors (neonatal sepsis, days on oxygen, blood transfusion) was recorded in a questionnaire then analysed.Results103 infants were included in the study. Mean gestational age was 29.9 ± 2.2 weeks and the mean birth weight was 1280.1 ± 333.0 grams. Forty-three infants were diagnosed with ROP, a prevalence of 41.7%. Majority of these had Stage 1 or 2 ROP in Zone II, which spontaneously regressed with follow up. Nine infants were diagnosed with vision-threatening ROP (any Zone I disease or Stage 2/3 disease in Zone II with plus disease), a prevalence of 20.9%. All of these underwent laser treatment in the neonatal unit. The most significant risk factor was low gestational age. Other risk factors identified were: low birth weight and blood transfusions.ConclusionROP prevalence in sub-saharan Africa will match those in middle-income and high income countries in neonatal units with advanced care and low mortality.

<p>Profile, Visual Presentation and Burden of Retinal Diseases Seen in Ophthalmic Clinics in Sub-Saharan Africa</p>

“…Other retinovascular diseases worthy of note were hypertensive retinopathy (which has been previously reported on in the region), 16,17 retinopathy of prematurity (an emerging retinal disease of increasing importance in the region), [18][19][20] sickle cell retinopathy (proliferative and nonproliferative disease), and retinal artery occlusion. A significant number of these renovascular conditions are associated with systemic risk factors such as diabetes, hypertension, dyslipidemia and sickle cell hemoglobinopathy, which occurred as co-existing systemic disease in a significant number of study patients.…”

The treatment and risk factors of retinopathy of prematurity in neonatal intensive care units

“…The incidence of ROP in China is lower than that in African countries, such as Kenya, Burundi, and Ethiopia [ 30 ]. The incidence of ROP in Kenya was 41.7, and 20.9% of premature infants with ROP required treatment [ 31 ]. However, the incidence of ROP in our study is higher than that in European countries, such as Switzerland and Sweden [ 32 , 33 ].…”

Characteristics of babies referred for Retinopathy of prematurity screening and management to a tertiary eye hospital of Bangladesh, a database analysis

“…This is an important dataset for ROP screening compared to the numbers seen in the literature. [6][7][8][9][10] IIEH ROP experience shows how ROP screening and management services can be scaled up in a given hospital; from 50 ROP cases screened in year 2012 to a yearly average of 296 cases in the last 3 years is a giant step made forward. [2] The incidence of ROP among the referrals was 34.9%.…”

“…Elsewhere, reported incidence was calculated at 32 weeks of GA and there is clear difference between developed and developing countries whereby ROP incidence appears to be lower in the former and higher in the latter: France (22.3%), Sweden(25.5%), United kingdom (19.2%), India (37.2%), Kenya(40%), Saudi Arabia(41%), Iran (47.3%),Turkey(50.9%) and Istanbul (52.7%). [6,[11][12][13][14][15][16] Among the babies screened to have any ROP stage, 53% needed at least one treatment modality. However, this trend should be analyzed with caution as it does not necessarily mean there is a decrease in the ROP stage 4&5.…”