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Aim To estimate the prevalence of retinopathy of prematurity (ROP) and investigate the prediction and validity of WINROP (Weight, Insulin-Like Growth Factor-1, Neonatal Retinopathy of Prematurity), an online monitoring algorithm in preterm infants at an African low/medium income country (LMIC) based neonatal intensive care unit (NICU). Methods Data from the ROP screening proforma for preterm infants between January 2020 and December 31, 2022, with gestational age (GA) from 24 to 32 weeks were entered into the WINROP algorithm system which signals an ROP risk alarm based on weekly weight gain and was compared with ophthalmology examination findings. Sensitivity, specificity, negative and positive predictive values were calculated, and statistical analysis was performed using EPI INFO (version 7.2.2.6). Results There were 168 preterm infants that met WINROP criteria. The median birth weight was 1380 g (IQR: 1141–1570 g), ranging from 600 g to 2100 g, while the median gestational age at birth was 31 weeks (IQR: 29.0–32.0 weeks), with a range of 24 to 32 weeks The overall prevalence of any ROP was 38.1% (64/168), type 1 ROP and type 2 ROP were 7.1% (12/168) and 8.9% (15/168) respectively. WINROP alarmed in 73 infants born at a gestational age (29.0 weeks, IQR: 28.0–31) and birth weight (1100 g, IQR: 912.5–1200 g). The specificity of WINROP for any ROP was 80.8% (84/104); the sensitivities for type 1 ROP and type 2 ROP were 91.7% (11/12) and 86.7% (13/15) respectively. The negative and positive predictive values were 88.4% (84/95) and 72.6% (53/73) respectively. Conclusion Overall, the WINROP algorithm identified 91.7% of preterm infants who had been diagnosed and treated for type 1 ROP. Though it led to a high number of false alarms, especially in the most vulnerable infants. The algorithm’s utility is likely greatest for the larger, more mature preterm infants. This confirms its usefulness to significantly reduce the number of preterm infants who need to go through stressful eye examinations in an African NICU setting where inadequate number of specialists is a major challenge.

The aim of the study was to define an intrauterine growth curve for a population of Nigerian newborn babies. A cross-sectional observational study design was adopted. Weight, length and head circumference were all measured in consecutive singleton deliveries at the University of Ilorin Teaching Hospital over a 3-year period. Gestational age (GA) of the babies was estimated from the last menstrual period or first trimester ultrasound. The estimates obtained were clinically validated using the Ballard score. Mean birth weights and percentiles of the weight, length and head circumferences for the respective GA were estimated using the SPSS 15 software package. A total of 5273 babies were recruited for the study with GA ranging from 25-44 weeks. Comparison of the mean birth weights of the various GA with the data from Denver, Colorado, showed that Nigerian babes tended to weigh less at the early GA, although these differences were not statistically significant. Between 26-36 weeks, the average weights of both sexes were similar; however, beyond this time point there was a consistent increase in the average weight of the males over the female babies. Growth curves for Nigerian newborn babies were generated and showed that the mean birth weight of Nigerian preterm babies was lighter than that of babies in Colorado. The impact of these differences on the classification of newborns will require further evaluation.

ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.DesignDescriptive case study.SettingNeonatal intensive care units in Nigeria.ParticipantsStaff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).Methods and analysisA WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017–2018 and to assess challenges in service provision.ResultsIn 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.ConclusionROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.