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

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 <1750g 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.