Unskilled health workers expose babies to blindness - study
What you need to know:
- The study states that inadequate screening knowledge among paediatricians and neonatal nurses of ROP predicts a high burden for Uganda, whose pre-term birth rate of 13.6 per every 1000 live births is ranked 28th in the world.
Majority of paediatricians and neonatal nurses in Uganda lack the knowledge needed to screen and detect retinopathy of prematurity, a condition that causes blindness among premature babies, a study has revealed.
The study done by researchers from Makerere University College of Health Sciences, on the knowledge, attitude and practice of paediatricians, neonatal nurses and parents of preterm infants at Kawempe National Referral Hospital and Mulago Specialised Women and Neonatal Hospital between August and November 2022, revealed that more than half of healthcare providers lacked the knowledge needed to screen premature babies for retinopathy of prematurity (ROP).
While releasing the findings of the study on Wednesday, the lead researcher, Dr Rebecca Claire Lusobya, an Ophthalmologist at Mulago National Referral Hospital, said the study discovered that only 14 out of the 68 healthcare workers sampled at the two hospitals, had ever received training on screening and prevention of ROP.
In addition, about 50 per cent of the respondents said they always referred such cases to eye specialists.
“There is a knowledge gap about ROP screening, which affects the eyes of these babies born early. Many years ago, most of these babies were not surviving but because the healthcare system and the paediatricians have worked so hard to ensure they survive, there is this problem of the disease that affects them at the back of the eye and causes blindness or reduced vision,” Dr Lusobya said.
“Usually, when these babies are born, the blood vessels at the back of their eyes haven’t grown properly to cover the whole eye. So, as they are being treated with oxygen and other treatments, they stimulate these vessels to start developing and some of them may develop abnormally and bleed into the eyes, causing scarring and blindness of the eyes,” he added.
The study states that inadequate screening knowledge among paediatricians and neonatal nurses of ROP predicts a high burden for Uganda, whose pre-term birth rate of 13.6 per every 1000 live births is ranked 28th in the world.
According to Dr Lusobya, timely referral by one month of age of pre-term babies to eye specialists may guard premature babies against the disease.
“All preterm babies should have an eye exam before four weeks to six weeks of age. They should be referred to an eye specialist early enough so that we can detect and correct vessels that are developing abnormally,” she said.
She noted that every week, the clinic at Mulago only screens about three to five babies, yet there are so many born in Kawempe and Mulago Women’s hospitals.
The researchers recommended training health workers in the neonatal units so that they are able to screen for the risk factors of ROP to promote early detection and referral of preterm infants at risk.
However, an assessment of the healthcare workers' knowledge of ROP showed satisfactory results with more than half of them stating that it is preventable if identified and treated early.
They also agreed that preterm babies in need of oxygen should have frequent eye checks.
Dr Mary Nyanzi, a paediatrician at Kawempe Referral Hospital, said some healthcare workers that are involved in the treatment of preterm babies are not aware of the screening and when to screen exactly.
Dr Nyanzi said of every eight babies born at Kawempe National Referral Hospital, 60 to 70 per cent are likely to be preterm.
She said common causes of preterm births include maternal conditions such as hypertension, pre-eclampsia, bleeding during pregnancy and infections, among others.
On the part of parents and caregivers, the study found that only 17 out of 146 of those interviewed had knowledge about the disease and its risk factors and only three of them knew how to identify it. This further contributes to gaps in screening and testing.