多学科干预对乌干达坎帕拉降低早产儿严重视网膜病变的影响。

The impact of a multidisciplinary intervention to reduce severe retinopathy of prematurity in Kampala, Uganda.

作者信息

Nakibuuka Victoria, Vaucher Yvonne E, Namakula Lucy, Kasozi Sarah, Zhang Jason, Ells Anna L, Blair Mike P, Isenberg Sherwin J, Lambert Scott R, Rodriguez Sarah H

机构信息

St. Francis Hospital Nsambya, Kampala, P.O. Box 7146, Uganda.

Division of Neonatology, Department of Pediatrics, University of California San Diego, San Diego, CA, 92037-7774, USA.

出版信息

J Perinatol. 2025 Feb;45(2):208-212. doi: 10.1038/s41372-024-02079-y. Epub 2024 Jul 30.

DOI:10.1038/s41372-024-02079-y

PMID:39080403

Abstract

BACKGROUND

To address the threat of retinopathy of prematurity (ROP) in Sub-Saharan Africa (SSA), the Stop Infant Blindness in Africa (SIBA) project introduced a comprehensive program, including subspecialty training and oxygen management equipment.

METHODS

A before-and-after retrospective cohort study compared preterm infants < 1750 g or < 34 weeks' gestation before (2022) and after (2023) program implementation. Outcomes included: the proportion with severe ROP, the proportion with Zone III vascularization on first examination, and factors associated with severe ROP.

RESULTS

Overall, 140 infants were screened before and 122 after program implementation. The proportion with Zone III vascularization increased from 16.1% (N = 11) pre-intervention to 44.9% (N = 32) post-intervention (p = 0.001). The proportion with severe ROP decreased from 27.8% (N = 19) to 12.8% (N = 9, p = 0.03). Factors predicting severe ROP on adjusted analyses were gestational age and blood transfusion.

CONCLUSION

In SSA, introduction of a comprehensive program to prevent and treat ROP can decrease the risk of severe ROP.

摘要

背景

为应对撒哈拉以南非洲地区（SSA）早产儿视网膜病变（ROP）的威胁，“非洲预防儿童失明”（SIBA）项目推出了一项综合计划，包括专科培训和氧气管理设备。

方法

一项前后回顾性队列研究比较了该计划实施前（2022年）和实施后（2023年）出生体重<1750克或胎龄<34周的早产儿。结果包括：重度ROP的比例、首次检查时III区血管化的比例以及与重度ROP相关的因素。

结果

总体而言，计划实施前筛查了140名婴儿，实施后筛查了122名婴儿。III区血管化的比例从干预前的16.1%（N = 11）增加到干预后的44.9%（N = 32，p = 0.001）。重度ROP的比例从27.8%（N = 19）降至12.8%（N = 9，p = 0.03）。调整分析中预测重度ROP的因素是胎龄和输血。