A tool for planning retinoblastoma services in sub-Saharan Africa.
Cancer care remains inadequate in low-middle income countries (LMICs). Children with cancer have 80% chance of surviving in high-income countries compared to 20% in LMICs. Retinoblastoma (RB), an aggressive eye cancer of childhood and top childhood cancer in sub-Saharan Africa (SSA), has a low survival rate, due to a delay in diagnosis and abandonment of treatment. The purpose of this study is to provide a tool for planning human resources required to manage RB in SSA.



Online tool was developed with 19 modifiable fields and 23 estimates. Routine data were used to populate modifiable fields: population, birthrate, infant mortality rate, and total fertility rate. Values were held constant: frequency, 1:17,000; familial cases, 8%; unilateral RB, 74%; extraocular disease, 70%; and survival postextraocular treatment, 10%.



One thousand twenty-three RB incident and familial cases are estimated each year across Ethiopia, Ghana, Malawi, Nigeria, Tanzania, Uganda, Zambia, and Zimbabwe: 75 familial, 700 unilateral, 717 extraocular disease, and 645 palliative. Nigeria represents 431 cases and Zimbabwe 33 cases. Over the eight countries, a total of 41,558 patient visits are estimated each year consisting of unilateral enucleation, follow-up visits, intensive treatment, and familial screening, with a total of 2,802 prosthetic eyes being required each year.



In the absence of data, estimates are essential for planning countrywide medical services. More attention is needed around planning for services from the Ministry level including emphasis on building multidisciplinary teams for diseases such as RB, including countrywide database and integrated clinical practice guidelines among all levels of care.
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
Lindsay
L
Hampejsková
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
Covadonga
C
Bascaran
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
Marcia
M
Zondervan
D017954:Africa South of the Sahara / Q000453:epidemiology; D002648:Child; D057210:Delayed Diagnosis / Q000517:prevention & control*; D003695:Delivery of Health Care; D055088:Early Detection of Cancer / Q000592:standards*; D006297:Health Services Accessibility; D006801:Humans; D010347:Patient Care Planning / Q000592:standards*; D011379:Prognosis; D016730:Program Development; D012175:Retinoblastoma / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors
childhood blindness; childhood cancer sub-Saharan Africa; childhood eye cancer; retinoblastoma; retinoblastoma sub-Saharan Africa