Expanding ROP Care in Sub-Saharan Africa

On World/Universal Children’s Day,  Dr. Paul Chan, Dr. Marilyn Miller and Dr. Sherwin Isenberg, leaders of the International Pediatric Ophthalmology and Strabismus Council ROP Taskforce on how they are bringing together international collaborators to define the scope and current state of ROP in Sub-Saharan Africa. 

Globally, there is an emerging epidemic of children at risk for blinding eye disease due to retinopathy of prematurity (ROP). ROP is a vascular condition of the developing retina that affects premature children. In many countries in Sub-Saharan Africa, ROP has not been considered a significant cause of blindness due to the underdevelopment of neonatal intensive care units and high neonatal mortality rate. Blindness prevention in these regions has been focused on more prevalent causes of childhood blindness, such as congenital cataract and refractive error. However, as neonatal mortality decreases in certain regions, ROP is a growing problem as screening and treatment programmes for ROP do not exist in many parts of Sub-Saharan Africa. The combination of decreasing neonatal mortality rate and the absence of ROP screening programmes is leading to an epidemic of childhood blindness in the continent.

In 2016, the International Pediatric Ophthalmology & Strabismus Council (IPOSC) created a task force focused on bringing together international collaborators to define the scope and current state of ROP in Sub-Saharan Africa. The goals of the Task Force are:

• Promote programmes and research to reduce childhood blindness from ROP.
• Encourage the development of institutions and trained practitioners to improve ROP care.
• Assist educational efforts through improved education of practitioners and the public
• Provide effective communications between local, national, and supra-national societies to coordinate ROP education, training, clinical care, and research.
• Facilitate collaboration with international foundations and non-governmental organizations to promote and enhance ROP care.

In September 2018, IPOSC and its collaborators hosted an international two-day clinical symposium and hands-on workshop at the Red Cross Memorial Children’s Hospital in Cape Town, South Africa.

With the generous support of the Knights Templar Eye Foundation, Inc., Novartis International, Phoenix Technology Group, Dr. Kunle Hassan, Dr. Anna Ells, Ms. Catherine Alexander, the Division of Global Ophthalmology at the Illinois Eye and Ear Infirmary of the University of Illinois at Chicago (UIC), and several other impassioned donors, ROP teams from Sub-Saharan Africa were awarded educational grants that allowed them to attend this programme. These teams were from Nigeria, Ghana, Zimbabwe, Nairobi and Ethiopia.

Over 100 participants were in attendance with thirty-nine international faculty from 8 countries working closely with the trainees from Africa. Hands-on workshops, hosted in the state-of-the-art Surgical Skills Training Centre, fostered live training by the world’s top ROP experts. The goal was for participants and the ROP teams to gain additional skills and resources to

1. identify existing human resources in nursing, neonatology, anesthesia, and ophthalmology;
2. identify potential sites for programme development based on existing human resources, infrastructure, motivated leadership;
3. initiate dialogue with appropriate ministries of health for support.

IPOSC and its international partners in ROP care are leading efforts to mentor and provide training to healthcare providers around the world to diagnose, manage, and develop programmes for ROP care. Together, we hope to support a community of ROP providers in Africa that will help effectively address the needs of children at risk for this blinding condition.

Image on Top: Imaging expert Leslie MacKeen left is shown steadying this practice baby head for a training physician

Additional Resources:

https://iposc.org/

https://www.everypreemie.org/donoharmbriefs/

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