Comparison of Tele Screening for Retinopathy of Prematurity Screening and Impact of Neonatal Team Support in Government and Private Centers in Rural Bijapur District of Southern India

ABSTRACT

Purpose: To compare the incidence of retinopathy of prematurity (ROP) with neonatal support provided during tele-ROP screening between government and private hospitals in rural Bijapur district of Karnataka. Methods: One government and four private hospitals under the ROP screening program between July 2011 and July 2012 were included. All infants born <2000 g at birth were imaged on a weekly basis. Centers were classified as “supportive” or “non-supportive” based on the support extended to the visiting team. Yield of enrollment and disease burden were compared between the centers. Results: Of the 145 infants analyzed, the mean incidence of any stage and treated ROP in the government center was 27.3% and 0% versus 36.6% and 9.7% in the private units, respectively. The proportion of infants enrolled in the government hospital was 40.7% versus 88.9% (mean) in the private hospitals. In the two “supportive” hospitals, the enrollment was 100% and 159.3% respectively, whereas it was 38.7% and 58.7% respectively in “non-supportive” units. Conclusions: The incidence of ROP in rural Bijapur is comparable to urban centers in India. Good pediatric and nursing support enhances infant enrollment into an ROP screening program. Private hospitals may have higher treatable ROP because of the sicker infants they admit. The report emphasizes the need to strengthen ROP screening programs in rural India.