Retinopathy of Prematurity as seen in two major hospitals in Nairobi, Kenya

Abstract

Aim : To determine the incidence, pattern and risk factors for Retinopathy of Prematurity (ROP) in Kenya (a developing country). Design: Non-comparative cohort study. Setting: Kenyatta National Hospital (KNH) a nd Pumwani maternity hospital (PMH) newborn units, November 2003 to April 2004. Subjects: 120 consecutive low birth weight preter m babies (55 from KNH and 65 from PMH). Results: A total of 240 eyes of 120 preterm babies we ighing between 800g and 1750g were examined for the presence of ROP. At the end of the follow-up period, 16.7% had developed different stages of the disease (c umulative incidence). Mild ROP occurred in 18 (15.0%) and severe ROP in 2 (1.6%) of the babies. Only one baby (0.8%) had threshold ROP. This study did not find a ny stage 4 or 5 ROP. Duration of oxygen therapy, gestational age, bi rth weight, sepsis and blood transfusion were the most important known risk factors. On multivariate logistic regression analysis, only duration of oxygen therapy was independent ly associated with ROP. The study did not find any significant statistical association between the c onsidered maternal risk factors and ROP. Conclusions : Incidence of ROP in this cohort of preterm black African babies was lower compared to centres in developed countries and presented as mild ROP. The duration of oxygen therapy was found to independently predispose the babies to ROP. Recommendations: There is need to monitor the trend of ROP in Kenya. Newborn babies on continuous oxygen administration should be closely monitored. Routine screening of babies above 32 week s gestation may not be required.