3
|
Ademola-Popoola DS, Fajolu IB, Gilbert C, Olusanya BA, Onakpoya OH, Ezisi CN, Musa KO, Chan RVP, Okeigbemen VW, Muhammad RC, Malik ANJ, Adio AO, Bodunde OT, Rafindadi AL, Oluleye TS, Tongo OO, Badmus SA, Adebara OV, Padhi TR, Ezenwa BN, Obajolowo TS, Olokoba LB, Olatunji VA, Babalola YO, Ugalahi MO, Adenekan A, Adesiyun OO, Sahoo J, Miller MT, Uhumwangho OM, Olagbenro AS, Adejuyigbe EA, Ezeaka CVC, Mokuolu O, Ogunlesi TA, Ogunfowora OB, Abdulkadir I, Abdullahi FL, Fabiyi AT, Hassan LHL, Baiyeroju AM, Opara PI, Oladigbolu K, Eneh AU, Fiebai BE, Mahmud-Ajeigbe FA, Peter EN, Abdullahi HS. Strengthening retinopathy of prematurity screening and treatment services in Nigeria: a case study of activities, challenges and outcomes 2017-2020. BMJ Open Ophthalmol 2021; 6:e000645. [PMID: 34514173 PMCID: PMC8383855 DOI: 10.1136/bmjophth-2020-000645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/02/2021] [Indexed: 11/04/2022] Open
Abstract
Objectives Retinopathy 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. Design Descriptive case study. Setting Neonatal intensive care units in Nigeria. Participants Staff 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 analysis A 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. Results In 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. Conclusion ROP 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.
Collapse
Affiliation(s)
- Dupe S Ademola-Popoola
- Department of Ophthalmology, University of Ilorin, Ilorin, Kwara, Nigeria.,Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Iretiola B Fajolu
- Department of Neonatology/Perinatology, Paediatrics, University of Lagos College of Medicine/ Lagos University Teaching Hospital, Lagos, Nigeria
| | - Clare Gilbert
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Bolutife A Olusanya
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Oluwatoyin H Onakpoya
- Retinal Unit, Department of Ophthalmology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun, Nigeria
| | - Chinyelu N Ezisi
- Pediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi, Nigeria
| | - Kareem O Musa
- Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
| | - Robison Vernon Paul Chan
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Valentina W Okeigbemen
- Paediatric Ophthalmology Unit, Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo, Nigeria
| | - Rilwan C Muhammad
- Department of Ophthalmology, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | | | - Adedayo O Adio
- Paediatric Ophthalmology Unit, Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
| | - Olubunmi T Bodunde
- Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Abdulkadir L Rafindadi
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Tunji S Oluleye
- Vitreoretinal Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Olukemi O Tongo
- Department of Paediatrics, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Sarat A Badmus
- Paediatric Ophthalmology Unit, Department of Ophthalmology, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - Olufunmilayo V Adebara
- Neonatal Unit, Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Tapas Ranjan Padhi
- Vitreoretinal Services, LV Prasad Eye Institute Bhubaneswar Campus, Bhubaneswar, India
| | - Beatrice N Ezenwa
- Department of Neonatology/Perinatology, Paediatrics, University of Lagos College of Medicine/ Lagos University Teaching Hospital, Lagos, Nigeria
| | - Tokunbo S Obajolowo
- Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Lateefat B Olokoba
- Vitreoretinal Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Victoria A Olatunji
- Vitreoretinal Unit, Department of Ophthalmology, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Yewande Olubunmi Babalola
- Vitreoretinal Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Mary O Ugalahi
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Adetunji Adenekan
- Vitreoretinal Unit, Department of Ophthalmology, University of Lagos, Lagos, Nigeria
| | - Omotayo O Adesiyun
- Department of Paediatrics, University of Ilorin Teaching Hospital, Ilorin, Kwara, Nigeria
| | - Jagdish Sahoo
- Neonatology, IMS and SUM Hospital, Kalinga Nagar, Bhubaneswar, Odisha, India, Bhubaneswar, Odisha, India
| | - Marilyn T Miller
- Department of Ophthalmology, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Odarosa M Uhumwangho
- Vitreoretinal Unit, Department of Ophthalmology, University of Benin Teaching Hospital, Benin City, Edo, Nigeria
| | - Adeduntan S Olagbenro
- Department of Ophthalmology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Ebunoluwa A Adejuyigbe
- Peadiatrics and Child Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
| | - Chinyere V C Ezeaka
- Department of Neonatology/Perinatology, Paediatrics, University of Lagos College of Medicine/ Lagos University Teaching Hospital, Lagos, Nigeria
| | - Olugbenga Mokuolu
- Neonatal Unit, Department of Paediatrics, University of Ilorin, Ilorin, Kwara, Nigeria
| | - Tinuade A Ogunlesi
- Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Olusoga B Ogunfowora
- Department of Paediatrics, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria
| | - Isa Abdulkadir
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Fatima L Abdullahi
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Abosede T Fabiyi
- Special Care Baby Unit, Nursing Service, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Laila H L Hassan
- Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Aderonke M Baiyeroju
- Paediatric Ophthalmology & Strabismus Unit, Department of Ophthalmology, College of Medicine, University of Ibadan and University College Hospital, Ibadan, Oyo, Nigeria
| | - Peace I Opara
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
| | - Kehinde Oladigbolu
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Augusta U Eneh
- Department of Paediatrics, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
| | - Bassey E Fiebai
- Vitreoretinal Unit, Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers, Nigeria
| | - Fatima A Mahmud-Ajeigbe
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Elijah N Peter
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Hawwa S Abdullahi
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| |
Collapse
|
9
|
Kim CY, Jung E, Kim EN, Kim CJ, Lee JY, Hwang JH, Song WS, Lee BS, Kim EAR, Kim KS. Chronic Placental Inflammation as a Risk Factor of Severe Retinopathy of Prematurity. J Pathol Transl Med 2018; 52:290-297. [PMID: 30008195 PMCID: PMC6166017 DOI: 10.4132/jptm.2018.07.09] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/09/2018] [Indexed: 12/20/2022] Open
Abstract
Background Chronic placental inflammation (CPI) has been implicated in the pathogenesis of diseases in premature infants, whereas retinopathy of prematurity (ROP) is a major complication primarily affecting preterm and very low-birth-weight (VLBW) infants. This study aims to investigate the association between CPI and ROP in VLBW infants. Methods We performed a retrospective review of clinical records of VLBW infants born between 2013 and 2016. Placental pathology findings including CPI cases were analyzed using logistic regression to study infants’ morbidities and other clinical characteristics. Results A total of 402 infants with a mean (standard deviation) gestational age of 28.5 (2.8) weeks and birth weight of 1,027.2 (304.4) g were included. The incidence of ROP was 24.1%. CPI was found in 90 infants (22.4%), among which 28.9% (26 of 90) developed ROP, and 21.1% (19 of 90) underwent laser photocoagulation. Lower gestational age, lower birth weight, longer duration of oxygen supply, and presence of CPI were associated with the development of ROP. After adjustment for gestational age, birth weight, sex, duration of oxygen supply, and other overlapping placental pathology, CPI was associated with the odds for type 1 ROP that required laser photocoagulation (adjusted odds ratio, 2.739; 95% confidence interval, 1.112 to 6.749; p = .029). Conclusions CPI was associated with severe ROP requiring treatment with laser photocoagulation in VLBW infants.
Collapse
Affiliation(s)
- Chae Young Kim
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Euiseok Jung
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Na Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Jai Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Yong Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji Hye Hwang
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Sun Song
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Byong Sop Lee
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ellen Ai-Rhan Kim
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Soo Kim
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
10
|
Nicolau Y, Bany-Mohammed F, Cai CL, Aranda JV, Beharry KD. SiRNA silencing of VEGF, IGFs, and their receptors in human retinal microvascular endothelial cells. Am J Transl Res 2018; 10:1990-2003. [PMID: 30093937 PMCID: PMC6079130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/14/2018] [Indexed: 06/08/2023]
Abstract
Vascular endothelial growth factor (VEGF) is a potent mitogen that regulates proliferation, migration, and tube formation of endothelial cells (EC). VEGF has recently become a target for severe retinopathy of prematurity (ROP) therapy. We tested the hypothesis that a specific VEGF isoform and/or receptor acts synergistically with insulin-like growth factor (IGF)-I to alter normal retinal microvascular EC angiogenesis and RNA interference can be used to reverse VEGF effects. We used small interfering RNA (SiRNA) transfection to target VEGF isoforms, IGFs, and their receptors in human retinal microvascular endothelial cells (HRECs). Media was collected at 24 and 48 hours post transfection for measurement of VEGF, sVEGFR-1 and IGF-1 levels; and HRECs were assessed for migration, tube formation, VEGF signaling genes, oxidative stress, and immune-reactivity. At 24 hours post transfection VEGF increased with VEGFR-2; sVEGFR-1 decreased with VEGF165, VEGFR-2, and IGF-1R; and IGF-I increased with VEGF189, VEGFR-1, IGF-2R, IGF+VEGF165, and IGF+VEGF121. IGF-I transfection with each VEGF isoform reduced sphere- forming and migration capacities with robust upregulation of caspase-9, COX-2, MAPK, PKC, and VEGF receptors. At 48 hours, the effects were reversed with a majority of genes downregulated, except with IGF-I and NP-1 transfection. Using RNA interference for targeted inhibition of VEGF isoforms in conjunction with IGF-I may be preferable for suppression of HREC overgrowth in vasoproliferative retinopathies such as ROP.
Collapse
Affiliation(s)
- Yona Nicolau
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of California IrvineIrvine, CA 92868, USA
| | - Fayez Bany-Mohammed
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of California IrvineIrvine, CA 92868, USA
| | - Charles L Cai
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine State University of New York, Downstate Medical CenterBrooklyn, NY 11203, USA
| | - Jacob V Aranda
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine State University of New York, Downstate Medical CenterBrooklyn, NY 11203, USA
- Department of Ophthalmology, State University of New York, Downstate Medical CenterBrooklyn, NY 11203, USA
- State University of New York Eye InstituteNew York, NY 10075, USA
| | - Kay D Beharry
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine State University of New York, Downstate Medical CenterBrooklyn, NY 11203, USA
- Department of Ophthalmology, State University of New York, Downstate Medical CenterBrooklyn, NY 11203, USA
- State University of New York Eye InstituteNew York, NY 10075, USA
| |
Collapse
|