Leading gynaecologists, neonatologists, paediatricians and ophthalmologists of Bangladesh have suggested conducting mass awareness campaigns on retinopathy of prematurity (ROP), a leading cause of childhood blindness, to save the sight of thousands of premature babies annually.
They said people and even many physicians are not aware of aspects of ROP – its risks and consequence and proper management – which is a major barrier to prevention of the disease.
The top physicians made the suggestions while speaking at a two-day “Workshop on ROP” held at Holiday Inn in the capital. The Department of Neonatology at the Bangabandhu Sheikh MujibMedical University (BSMMU) and Orbis International organised the workshop, which ended on Thursday.
ROP is a vaso-proliferative disorder affecting the retina of premature and low birth-weight neonates. If not detected and treated timely, it can quickly progress to blinding stage while timely screening — between 20 and 30 days of life — and treatment in early stage can prevent blindness.
According to official data, more than 3 million babies are born annually in Bangladesh — approximately 12.5 percent or 400,000 prematurely with the risk of being affected with ROP.
Directorate General of Health Services Director General Prof MdAbu Jafor, also a renowned paediatric surgeon, joined, as the chief guest, the workshop presided over by BSMMU Neonatology Department Chairman Prof Abdul Mannan.
Bangladesh College of Physicians and Surgeons President Prof Mohammod Shahidullah, also a neonatologist, veteran paediatrician Prof Nazmun Nahar, Bangladesh Prenatal Society President gynaecologist Prof Laila Arjumand Banu, neonatologist Prof Abid Hossain Mollah, BSMMU Ophthalmology Department Associate Professor Tariq Reza Ali, and Bangladesh Neonatal Forum President Prof Munir Hossain and Secretary General Prof Sanjoy Kumar Dey also spoke at the event.
Doctors from gynaecology, neonatology, paediatrics and ophthalmology departments of medical colleges and health facilities from across the country, and other stakeholders participated in the workshop.
The institutions they represent include BSMMU, Dhaka Medical College, Sir Salimullah Medical College, Shaheed SuhrawardyMedical College, Rajshai Medical College, Chattagram Medical College, Sylhet MAG Osmani Medical College, MymensingMedical College, Rangpur Medical College, Faridpur Medical College, Cox’s Bazar Medical College, Patuakhali Medical College, Combined Military Hospital Dhaka, Birdem General Hospital, Bangladesh Shishu Hospital and Institute, ChattagramMaa-O-Shishu Hospital, Cox’s Bazar General Hospital, Dr MR Khan Shishu Hospital & Institute of Child Health, Ashulia Women and Children Hospital, Deep Eye Care Foundation, Rangpur and Institute of Child and Mother Health, Matuail.
Speaking at the workshop, Prof Abu Jafor said combined efforts of ophthalmologists, neonatologists and nurses are necessary to detect and manage ROP cases. He said ROP screening and treatment have to be decentralised to cover more people.
Putting emphasis on awareness creation, he said, “Awareness, particularly among physicians, is critically important for ROP prevention as they are not well aware of the disease.”
Prof Shahidullah said the responsibility of ROP screening should not be confined only to ophthalmologists, it should be done by neonatologists, paediatricians and Retcamp nurses in line with the practice of other countries.
“We need to ensure that no preterm or low birthweight baby, qualifying for ROP screening, is left out,” he said.
Prof Nazmun Nahar said Orbis is doing tremendous work for preventing avoidable blindness, but they need to further expand their programmes to cover more areas and conduct campaigns to aware people of the necessity of ROP screening for premature babies.
“When we, doctors, are not adequately aware of ROP, how ordinary people will know about it. The mothers will not be interested in ROP screening of their preterm babies unless and until they know the risk,” she said.
A protocol should be formulated on ROP screening and management for physicians to follow for combating the disease.
Prof Laila Arjumand said ROP screening and management are growingly getting important with the increase in the number of babies born through assistant reproductive technology like test tube babies, most of whom are born prematurely.
She said there should be a committee comprising gynaecologists, paediatricians, neonatologists and ophthalmologists at every health facility where test tube babies are born and at every tertiary hospital.
She said a guideline should be formulated and put into force on the prevention and management ROP. Awareness campaigns through mass media are also necessary to create awareness among the parents, she added.
Referring to high tetanus vaccination rate, which crossed 95 percent among pregnant women, she said, “It will bring tremendous results if we can reach the message to mothers that unless your preterm or low birthweight babies are screened for ROP, they can lose vision.”
Prof Munir Hossain said ROP screening and management facility should be ensured at all old medical colleges.
Prof Sanjoy Kumar said the improvement in healthcare system results in a reduction of neonatal deaths but all preterm and low birthweight babies need to be screened for ROP for their quality survival.
Prof Abdul Mannan said that despite the written advice by doctors at medical facilities for ROP screening, parents often missed the test for their preterm babies in time due to the lack of awareness.
“Many doctors even don’t know the necessity of ROP screening and timely treatment of babies at risk. They sometimes misguide the parents,” he said.