BMJ Open Ophthalmology (Sep 2021)
Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020
- Robison Vernon Paul Chan,
- Kehinde Oladigbolu,
- Clare Gilbert,
- Beatrice N Ezenwa,
- Isa Abdulkadir,
- Aeesha N J Malik,
- Iretiola B Fajolu,
- Olukemi O Tongo,
- Tapas Ranjan Padhi,
- Dupe S Ademola-Popoola,
- Kareem O Musa,
- Ebunoluwa A Adejuyigbe,
- Tinuade A Ogunlesi,
- Bolutife A Olusanya,
- Oluwatoyin H Onakpoya,
- Chinyelu N Ezisi,
- Valentina W Okeigbemen,
- Rilwan C Muhammad,
- Adedayo O Adio,
- Olubunmi T Bodunde,
- Abdulkadir L Rafindadi,
- Tunji S Oluleye,
- Sarat A Badmus,
- Olufunmilayo V Adebara,
- Tokunbo S Obajolowo,
- Lateefat B Olokoba,
- Victoria A Olatunji,
- Yewande Olubunmi Babalola,
- Mary O Ugalahi,
- Adetunji Adenekan,
- Omotayo O Adesiyun,
- Jagdish Sahoo,
- Marilyn T Miller,
- Odarosa M Uhumwangho,
- Adeduntan S Olagbenro,
- Chinyere V C Ezeaka,
- Olugbenga Mokuolu,
- Olusoga B Ogunfowora,
- Fatima L Abdullahi,
- Abosede T Fabiyi,
- Laila H L Hassan,
- Aderonke M Baiyeroju,
- Peace I Opara,
- Augusta U Eneh,
- Bassey E Fiebai,
- Fatima A Mahmud-Ajeigbe,
- Elijah N Peter,
- Hawwa S Abdullahi
Affiliations
- Robison Vernon Paul Chan
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
- Kehinde Oladigbolu
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Clare Gilbert
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Beatrice N Ezenwa
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
- Isa Abdulkadir
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
- Aeesha N J Malik
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
- Iretiola B Fajolu
- Department of Paediatrics, Lagos University Teaching Hospital, Surulere, Nigeria
- Olukemi O Tongo
- Institute of Child Health, University College Hospital Ibadan, Ibadan, Nigeria
- Tapas Ranjan Padhi
- Vitreoretinal services,Mithu Tulsi Chanrai Campus, LV Prasad Eye Institute, Bhubaneswar Campus, Bhubaneswar, Odisha, India
- Dupe S Ademola-Popoola
- Department of Ophthalmology, University of Ilorin, Ilorin, Kwara, Nigeria
- Kareem O Musa
- Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
- Ebunoluwa A Adejuyigbe
- Peadiatrics and Child Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
- Tinuade A Ogunlesi
- Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
- Bolutife A Olusanya
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
- Oluwatoyin H Onakpoya
- Retinal Unit, Department of Ophthalmology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun, Nigeria
- Chinyelu N Ezisi
- Pediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi, Nigeria
- Valentina W Okeigbemen
- Paediatric Ophthalmology Unit, Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo, Nigeria
- Rilwan C Muhammad
- Department of Ophthalmology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
- Adedayo O Adio
- Paediatric Ophthalmology Unit, Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
- Olubunmi T Bodunde
- Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
- Abdulkadir L Rafindadi
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Tunji S Oluleye
- Vitreoretinal Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
- Sarat A Badmus
- Paediatric Ophthalmology Unit, Department of Ophthalmology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
- Olufunmilayo V Adebara
- Neonatal Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
- Tokunbo S Obajolowo
- Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
- Lateefat B Olokoba
- Vitreoretinal Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
- Victoria A Olatunji
- Vitreoretinal Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
- Yewande Olubunmi Babalola
- Vitreoretinal Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
- Mary O Ugalahi
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
- Adetunji Adenekan
- Vitreoretinal Unit, Department of Ophthalmology, University of Lagos, Lagos, Nigeria
- Omotayo O Adesiyun
- Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
- Jagdish Sahoo
- Neonatology, IMS and SUM Hospital, Kalinga Nagar, Bhubaneswar, Odisha, India, Bhubaneswar, Odisha, India
- Marilyn T Miller
- Department of Ophthalmology, University of Illinois College of Medicine, Chicago, Illinois, USA
- Odarosa M Uhumwangho
- Vitreoretinal Unit, Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo, Nigeria
- Adeduntan S Olagbenro
- Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
- Chinyere V C Ezeaka
- Department of Neonatology/Perinatology, Paediatrics, University of Lagos College of Medicine/ Lagos University Teaching Hospital, Lagos, Nigeria
- Olugbenga Mokuolu
- Neonatal Unit, Department of Paediatrics, University of Ilorin, Ilorin, Kwara, Nigeria
- Olusoga B Ogunfowora
- Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
- Fatima L Abdullahi
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Abosede T Fabiyi
- Special Care Baby Unit, Nursing Service, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Laila H L Hassan
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Aderonke M Baiyeroju
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
- Peace I Opara
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
- Augusta U Eneh
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
- Bassey E Fiebai
- Vitreoretinal Unit, Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
- Fatima A Mahmud-Ajeigbe
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Elijah N Peter
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- Hawwa S Abdullahi
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
- DOI
- https://doi.org/10.1136/bmjophth-2020-000645
- Journal volume & issue
-
Vol. 6,
no. 1
Abstract
Objectives Retinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.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.
