A Novel, Low-Cost Method of Enrolling Infants at Risk for Retinopathy of Prematurity in Centers with No Screening Program: The REDROP Study

Abstract

Purpose: To report the first-year results of the Red Card for Retinopathy of Prematurity (REDROP) study, a low-cost interim strategy to enroll infants into retinopathy of prematurity (ROP) screening where limited expertise exists, piloted at a multi-specialty general hospital.

Methods: Red “warning” cards were placed alongside green “congratulations” cards above the weighing scale in the neonatal unit. Staff weighing the newborn were instructed to give either one of the cards to each mother depending on the weight of the child (≤ 2000 g, red, and > 2000 g, green). Red cards contained information (tri-lingual) about ROP and the venue of screening. Green cards contained general pediatric eye education and recipients were not called. A portion of the red card with the infant’s birth date and mother’s contact number was retained and collected weekly by volunteers. Mothers were reminded on the mobile phone to come for ROP screening. Screening and treatment were performed free.

Results: During the study period, 224 of 805 (27.8%) infants were born ≤ 2000 g. Of these, 169 (75.4%) survived and were eligible for the red card; 91 (53.8%) received it. Of these, 43 (47.3%) infants completed ROP screening, 14 (32.6%) had some stage ROP, and three (6.9%) required laser treatment. The main reason for the lower turnout for screening was the inability to contact mothers on their provided phone numbers.

Conclusions: REDROP demonstrates the feasibility of this low-cost method of enrolling unscreened infants into a ROP program. The cost of enrolling each infant was less than 5 rupees (US$0.10). Suggested strategies to improve use require multi-center validation.

KEYWORDS::

• Retinopathy of prematurity
• Middle-income
• Screening
• Low-cost
• REDROP

ACKNOWLEDGMENTS

The authors acknowledge the contribution of the Department of Pediatrics at Bowring General Hospital, Bangalore, the KIDROP (Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity) and the National Rural Health Mission, Ministry of Health and Family Welfare, Government of Karnataka, India.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.