Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register

Objective Retinopathy of prematurity (ROP) registers enable population-based studies to monitor ROP screening programmes to improve their effectiveness. The aim of this study was to determine the frequency of ROP and the coverage of screening in a South African cohort using a prospective ROP South A...

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Main Authors: Esme Jordaan, Rudzani Muloiwa, Adrie Bekker, Gerd Holmström, Clare Gilbert, Michael Harrison, Nicola Freeman, Lloyd Tooke, Phumza Nongena, Natasha Rhoda, Tshilidzi van der Lecq, Teboho Seobi, Linda Visser, Shakti Pillay, Nicole Meiring, Jaco Murray, Adriaan Daniels, Helga Abrahamse-Pillay, Gugulabatembunamahlubi Kali, Miemie Du Preez, Alexander Geragotellis
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:BMJ Open Ophthalmology
Online Access:https://bmjophth.bmj.com/content/10/1/e002036.full
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author Esme Jordaan
Rudzani Muloiwa
Adrie Bekker
Gerd Holmström
Clare Gilbert
Michael Harrison
Nicola Freeman
Lloyd Tooke
Phumza Nongena
Natasha Rhoda
Tshilidzi van der Lecq
Teboho Seobi
Linda Visser
Tshilidzi van der Lecq
Shakti Pillay
Nicole Meiring
Jaco Murray
Adriaan Daniels
Helga Abrahamse-Pillay
Gugulabatembunamahlubi Kali
Miemie Du Preez
Alexander Geragotellis
author_facet Esme Jordaan
Rudzani Muloiwa
Adrie Bekker
Gerd Holmström
Clare Gilbert
Michael Harrison
Nicola Freeman
Lloyd Tooke
Phumza Nongena
Natasha Rhoda
Tshilidzi van der Lecq
Teboho Seobi
Linda Visser
Tshilidzi van der Lecq
Shakti Pillay
Nicole Meiring
Jaco Murray
Adriaan Daniels
Helga Abrahamse-Pillay
Gugulabatembunamahlubi Kali
Miemie Du Preez
Alexander Geragotellis
collection DOAJ
description Objective Retinopathy of prematurity (ROP) registers enable population-based studies to monitor ROP screening programmes to improve their effectiveness. The aim of this study was to determine the frequency of ROP and the coverage of screening in a South African cohort using a prospective ROP South African (ROPSA) register.Methods and analysis Infants born from 1 May 2022 to 31 January 2023 and screened prospectively for ROP at five neonatal intensive care units in Cape Town were included. The screening criteria were a gestational age (GA) <32 weeks or birth weight (BW) <1250 g. Data were extracted from the ROPSA register and analysed.Results 696 of 1154 (60.3%) eligible infants were screened, almost half of whom (45.7%) did not complete screening. ROP was detected in 220 infants (31.6%, 95% CI 28.3% to 35.3%), 7 (1.0%) of whom required treatment. Infants with incomplete screening had a lower mean GA than those who completed screening; 28.7 (SD 1.6, range 25–33) and 29.1 (SD 1.7, range 24–36) weeks, respectively (p=0.004) and a lower mean BW; 1048 (SD 203, range 650–1690) g and 1108.5 (SD 227, range 640–1840) g, respectively (p<0.001).Conclusions Data from the ROPSA register on the frequency of any ROP and treatment-requiring ROP may be biased due to low screening coverage and high incomplete screening. Reasons need to be explored and corrective interventions initiated. The ROPSA register will enable the impact of these interventions to be monitored. The findings of this study will contribute to the ongoing revision of South African national ROP screening guidelines.
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spelling doaj-art-268727c23a2046ac84bfddcbff85a4ae2025-08-20T02:16:10ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-05-0110110.1136/bmjophth-2024-002036Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register Esme Jordaan0Rudzani Muloiwa1Adrie BekkerGerd Holmström2Clare Gilbert3Michael HarrisonNicola FreemanLloyd TookePhumza NongenaNatasha Rhoda4Tshilidzi van der Lecq5Teboho Seobi6Linda Visser7Tshilidzi van der Lecq8Shakti PillayNicole MeiringJaco MurrayAdriaan DanielsHelga Abrahamse-PillayGugulabatembunamahlubi KaliMiemie Du PreezAlexander GeragotellisBiostatistics Research Unit, South African Medical Research Council, Cape Town, South AfricaDepartment of Paediatrics & Child Health, University of Cape Town, Cape Town, South AfricaDepartment of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, SwedenClinical Research, London School of Hygiene & Tropical Medicine, London, UKDepartment of Paediatrics & Child Health, University of Cape Town, Cape Town, South AfricaDepartment of Surgery, Division of Ophthalmology, University of Cape Town, Cape Town, South AfricaDepartment of Surgery, Division of Ophthalmology, University of Cape Town, Cape Town, South AfricaOphthalmology, University of Stellenbosch, Cape Town, Western Cape, South AfricaMDObjective Retinopathy of prematurity (ROP) registers enable population-based studies to monitor ROP screening programmes to improve their effectiveness. The aim of this study was to determine the frequency of ROP and the coverage of screening in a South African cohort using a prospective ROP South African (ROPSA) register.Methods and analysis Infants born from 1 May 2022 to 31 January 2023 and screened prospectively for ROP at five neonatal intensive care units in Cape Town were included. The screening criteria were a gestational age (GA) <32 weeks or birth weight (BW) <1250 g. Data were extracted from the ROPSA register and analysed.Results 696 of 1154 (60.3%) eligible infants were screened, almost half of whom (45.7%) did not complete screening. ROP was detected in 220 infants (31.6%, 95% CI 28.3% to 35.3%), 7 (1.0%) of whom required treatment. Infants with incomplete screening had a lower mean GA than those who completed screening; 28.7 (SD 1.6, range 25–33) and 29.1 (SD 1.7, range 24–36) weeks, respectively (p=0.004) and a lower mean BW; 1048 (SD 203, range 650–1690) g and 1108.5 (SD 227, range 640–1840) g, respectively (p<0.001).Conclusions Data from the ROPSA register on the frequency of any ROP and treatment-requiring ROP may be biased due to low screening coverage and high incomplete screening. Reasons need to be explored and corrective interventions initiated. The ROPSA register will enable the impact of these interventions to be monitored. The findings of this study will contribute to the ongoing revision of South African national ROP screening guidelines.https://bmjophth.bmj.com/content/10/1/e002036.full
spellingShingle Esme Jordaan
Rudzani Muloiwa
Adrie Bekker
Gerd Holmström
Clare Gilbert
Michael Harrison
Nicola Freeman
Lloyd Tooke
Phumza Nongena
Natasha Rhoda
Tshilidzi van der Lecq
Teboho Seobi
Linda Visser
Tshilidzi van der Lecq
Shakti Pillay
Nicole Meiring
Jaco Murray
Adriaan Daniels
Helga Abrahamse-Pillay
Gugulabatembunamahlubi Kali
Miemie Du Preez
Alexander Geragotellis
Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
BMJ Open Ophthalmology
title Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
title_full Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
title_fullStr Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
title_full_unstemmed Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
title_short Screening for retinopathy of prematurity (ROP) in South Africa: data from a newly established prospective regional register
title_sort screening for retinopathy of prematurity rop in south africa data from a newly established prospective regional register
url https://bmjophth.bmj.com/content/10/1/e002036.full
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