Lessons learnt from polio eradication programme can help improve retinopathy of prematurity services in India: Lancet paper

Retinopathy of prematurity is a serious condition that affects the vision of premature infants, and in severe cases, it can lead to permanent blindness if not identified and treated in time

November 25, 2023 09:08 pm | Updated November 28, 2023 10:03 am IST - Bengaluru 

The Global Polio Eradication Initiative was a global effort to eradicate polio, which was once a major health threat in many countries, including India. File

The Global Polio Eradication Initiative was a global effort to eradicate polio, which was once a major health threat in many countries, including India. File | Photo Credit: The Hindu

Highlighting the success of the Global Polio Eradication Initiative (GPEI), doctors from Narayana Nethralaya and the University of Western Australia have said that lessons learnt from this initiative can help improve retinopathy of prematurity (ROP) services in India. A paper on this titled Retinopathy of prematurity in India: what can we learn from the polio legacy was recently published in Lancet Regional Health - Southeast Asia.

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ROP is a serious condition that affects the vision of premature infants, and in severe cases, it can lead to permanent blindness if not identified and treated on time. In India, where over 3.5 million pre-term infants are born each year, there are significant challenges in addressing ROP due to limited resources, lack of awareness among healthcare professionals and the public, and a vast at-risk population.

Co-authored by doctors Sam Athikarisamy and Sanjay Patole from the University of Western Australia, Perth, and Anand Vinekar from Narayana Nethralaya, who is the director of the Karnataka Internet-assisted Diagnosis of ROP (KIDROP), the Lancet article highlights the lessons that can be emulated from the successful GPEI to improve ROP services in India. 

The GPEI was a global effort to eradicate polio, which was once a major health threat in many countries, including India. The initiative involved mobilising political and social support, strategic planning and policy development, partnership management and donor coordination, programme operations and tactics, and oversight and independent monitoring. By applying these strategies, the GPEI was able to significantly reduce the number of polio cases and bring the disease close to eradication. 

Drawing on the success of the GPEI, the authors have proposed a similar comprehensive approach to address the challenges of ROP in India, given the magnitude of the problem and the expected demand for ROP services due to a high survival rate of preterm infants following advancements in neonatal care. 

Prevention

Elaborating on the article, Dr. Vinekar told The Hindu that the impact of untreated ROP can lead to permanent blindness with severe consequences for the affected child, family, and society. “ROP can be prevented through primary prevention measures such as reducing preterm births, improving neonatal practices such as nutrition and sepsis prevention, and ensuring proper oxygen stewardship. However, the unavailability of necessary equipment such as oxygen blenders and saturation monitors in many Special Newborn Care Units (SNCUs) is a barrier,” he asserted.

The authors proposed that “the future of neonatal care should prioritise safe delivery of oxygen through blenders and monitoring equipment, as well as an in-built referral system for ROP screening”. They suggested that “these features should be included as part of the commissioning process.”

“Preventing blindness due to ROP will require a public health crusade, much like the one against polio. To further address the challenges of ROP in India, the article calls for more commitment and coordination from the government, NGOs, and professional organizations, as well as from healthcare professionals including obstetricians, pediatricians, neonatologists, and ophthalmologists,” Dr. Vinekar pointed out.

“Influential brand ambassadors, such as Amitabh Bachchan, were critical in the success of the polio programme in India. They played a pivotal role in creating nationwide awareness about the disease through effective public messages in mass media, print, and social media. Similarly, to combat the challenge of ROP, India needs such influential ambassadors,” he added.

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