PREVALENCE AND FACTORS ASSOCIATED WITH RETINOPATHY OF PREMATURITY SCREENING IN PRETERM INFANTS AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA

Abstract

Abstract Introduction: Retinopathy of prematurity (ROP) remains a major, potentially preventable cause of blindness in preterm infants globally. With improved neonatal care and increased survival rates of preterm infants, ROP prevalence is rising, presenting a significant public health challenge. While timely screening, diagnosis, and treatment can prevent ROP-related blindness, national screening guidelines are lacking in many regions, particularly in Africa, where only two countries have implemented them. Objective: To determine the prevalence of screening practices for Retinopathy of prematurity as well as factors affecting it in preterm infants at St. Paul Hospital Millennium Medical College in the past 12 months. Methods: A hospital-based cross-sectional study was conducted among preterm infants who were admitted to the neonatal intensive care unit in St Paul Hospital Millennium Medical College between October 4 and December 4, 2025 G.C. The study was conducted on 296 preterm infants who were selected using a simple random sampling technique. The data was collected using an abstraction tool by the data collectors. The data was analyzed using SPSS version 27. The final result is presented in the form of a descriptive, bi-variable, and multi variable analysis. Result: A total of 296 neonates were included in the study. Among them, 16 were excluded because they had incomplete documentation. Taking the remaining 196 eligible neonates, who were alive at the age of screening, the overall prevalence of ROP screening was 43.4% (n=85). After adjusting for all covariates, only the link to the ophthalmology department and length of stay in NICU remain as statistically significant independent predictors of ROP screening status. Other variables, including gestational age (p = 0.101), birth weight (p = 0.677), CPAP support (p = 0.741), residential location (p = 0.070), and oxygen support (p = 0.791) initially had statistically significant associations in bi-variable analysis but were not independently associated with screening status in the adjusted model (multi-variable analysis). Conclusion: The overall prevalence of ROP screening among eligible neonates was substantially lower than that of high-income countries and lower-income countries with national guidelines. The analysis revealed that systemic and logistical factors, rather than clinical risk factors, were the independent predictors of whether an eligible infant received screening. Suggesting that, in St. Paul, the failure to screen is primarily a systemic failure of coordination and follow-up, rather than a failure to identify the clinically high-risk infant. Multi-centered studies and qualitative studies are recommended in order to gain a full insight of ROP screening status of the country. Keywords: Retinopathy of prematurity, screening, blindness