Abstract
Purpose :
The study focused on increasing awareness among the parents and health professionals regarding risk of retinopathy of prematurity(ROP), improving quality of care for preterm infants, ensuring early disease identification by timely screening, treatment and long-term follow-up of detected babies with ROP. The study was performed in five districts of South India.
Methods :
1) Improving quality of preterm care using training workshops at special new born care units(SNCU) aimed at capacity building with regards to risk factor and high-risk baby identification.
2) Sensitization of grassroot health workers (250 workers at village levels, 25 meets) ) to increase awareness about ROP. These health workers educate mothers about risk factors and need for ROP screening during antenatal visits.
3) SNCU nurses were trained in ROP imaging using wide-angle fundus camera, basic interpretation and counselling.The SNCU database was used to identify all eligible babies based on national ROP guidelines . A grading hub was established at the base hospital to provide image interpretation and management decision by a trained retinal specialist to facilitate near real time reporting.
4)The base hospital treated ROP based on recommendations of Early Treatment of Retinopathy of Prematurity (ETROP) study and national operational guidelines for prevention of blindness from ROP in India.
5) Long-term follow-up and low vision care for preterm infants was planned at District Early Intervention Centers (DEICs) by the incumbent optometrists which was supported initial low-vision training followed by monthly handholding sessions.
Results :
Screening centers for ROP: Nine SNCUs ( five tertiary and four secondary care) in Southern India
Total number of babies screened: 3749 in 13 months
70-75% of eligible babies screened
75 babies (2-3% of screened) required treatment
Around 30 babies (~40%) of babies treated with combination of injections followed by laser
Conclusions :
The study succintly demonstrated that with targetted upskilling, quality improvement and appropriate handholding, the existing health care machinery can be used to effectively prevent and manage a complex and skill-intensive condition such as ROP. The studies aspires to serve as a blue print in democraitising health care delivery using simple and efficacious interventions.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.