Rop en brazil dra andrea zin
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Brazil has a population of over 192 million people, with 28% under 15 years old. Childhood blindness affects an estimated 22,000 children in Brazil, or around 110 blind children per million. The leading causes of childhood blindness vary by region but include toxoplasmosis, congenital glaucoma, congenital cataract, and retinopathy of prematurity (ROP). For ROP specifically, it is estimated that of the approximately 36,995 babies born weighing less than 1,500g annually in Brazil, 15,538 will survive to one year of age, and of those 1,554 (10%) will have severe ROP requiring treatment. However, screening and treatment criteria for ROP in Brazil are not
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- 2. Current situation analysis in: Brazil Andrea Zin Departamento de Neonatologia/Unidade de Pesquisa Clinica Instituto Fernandes Figueira/FIOCRUZ Centro Colaborador OPS/OMS para Ceguera Infantil - ROP Rio de Janeiro, Brasil Asesora Medica CBM Subcomite Ceguera Infantil/IAPB
- 3. Brazil BRAZIL 8.5 millions Km IBGE estimates – pop. 2010 – 192,304,735 27 STATES 43%Southeast 28%Northeast 15%South 7% North 7%Middle-West www.datasus.gov.br
- 4. Under 5 mortality rates (U5MR) and estimates of blindness prevalence Courtesy C Gilbert
- 6. U5MR 20.6/1000 (World Bank)
- 8. Childhood Blindness No precise data available Lack of epidemiological studies and/or accurate registers of the blind Isolated reports from school for the blind and low vision services Isolated reports from screening programs Different criteria for blindness and low vision Data based on WHO and NGO reports
- 9. Childhood Blindness Toxoplasmosis – 21 to 31% Congenital glaucoma – 11 to 18% Congenital cataract – 7 to 19% ROP – 3 to 21%
- 11. Live births 2,934, 828
- 12. BW < 1500 g 36, 995
- 13. 70% access to NICU 25,896
- 14. 60% Survival rate < 1,500 15,538
- 21. Conselho Brasileiro de Oftalmologia
- 22. Sociedade Brasileira de Pediatria
- 23. # NICUS ?? Approx 300
- 24. RBPN: 32 NICUs
- 27. Brazilian Screening and Treatment Guidelines
- 28. ≤ 1,500 g and/or GA ≤ 32 weeks
- 30. 1st exam 4th week of life Arq Bras Oftalmol 2007; 70(5): 875-83
- 31. 17 Retinopathy of prematurity in 7 NICUs in Rio de Janeiro: screening criteria 2004-2006 Results Rates of any ROP and ROP needing treatment, by unit # Examined by AZ 1 Babies with either threshold or type 1 Zin et al, Pediatrics, 2010
- 32. 18 Retinopathy of prematurity in 7 NICUs in Rio de Janeiro: screening criteria 2004-2006 Results Plot of birth weight against gestational age of babies treated for ROP Survival ≤ 1,500 g ≥ 80% Survival ≤ 1,500 g < 80% Units 1 and 2 Units 3,4, 5, 6 and 7 Zin et al, Pediatrics, 2010
- 35. Questionnaire to NICUs: Screening criteria, available resources, work processes
- 36. All access to ROP exam and treatment
- 37. Screening and treatment criteria not standardized
- 38. No agenda, register book etc
- 39. Neonatal team does not have access to ROP data
- 42. Follow-up
- 43. 23