Abstract
Background: Retinoblastoma is the commonest intraocular childhood malignancy in the world and is curable when detected early. Delay in presentation and management is seen as a major contributor affecting outcome.
Objective: To determine the magnitude of delay in the presentation and management of retinoblastoma patients at the Kenyatta National Hospital.
Methodology: A cross sectional hospital based study done from November 2012 to April 2014 at the Kenyatta National Hospital. Data was collected using a semi structured questionnaire from the parents/guardians of retinoblastoma patients who gave consent.
Results: Ninety-one parents/guardians of 64 patients participated. Sixty point nine percent took more than 5 months from onset of symptoms to presentation at the referral centre while 46.1% took more than 1 month from onset of symptoms to first visit to a health facility. Ten point nine percent of patients took more than 2 weeks before starting definitive management at the referral centre.
Conclusions: Majority of the patients presented late to the referral centre while most of the health care providers referred the patients early. Augmentation of public awareness on retinoblastoma would make the primary caregivers more aware of early symptoms of the disease.
References
Kanski, J. Clinical Ophthalmology, A Systematic Approach. s.l. : Butterworth- Heinemann- Elsevier, 2007. ISBN-13: 978-0-08-044969-2.
Jamalia R, Sunder R, Alagaratnam P, Goh P, et al. Retinoblastoma registry report - Hospital Kuala Lumpur experience. Supplement A, Kuala Lumpar. Med J Malaysia. 2010; 65: 128 - 130.
Nyamori JM, Kimani K, Njuguna MW, Dimaras H. The incidence and distribution of retinoblastoma in Kenya. The Brit J Ophthalmol. 2012; 96: 141–143.
Ophthalmologists, American Academy of Ophthalmic Pathology and Intraocular Tumours: Section 4 - BCSC. Singapore : AAO, 2011 - 2012.
Lukusa AK, Aloni MN, Tshimanga BK, Muaka MM, Ehungu JLG, Ngiyulu R. Retinoblastoma in the Democratic Republic of Congo: 20-year review from a tertiary hospital in Kinshasa. Kinshasa. J Cancer Epidemiol. 2012; 2012. Article ID 920468.
Goddard AG, Kingston JE, Hungerford JL. Delay in diagnosis of retinoblastoma: risk factors and treatment outcome. The Brit J Ophthalmol. 1999; 83: 1320-3.
Ling-Yuh Kao, Wei-Wen Su, Ya-Wen Lin. Retinoblastoma in Taiwan: Survival and clinical characteristics 1978–2000. Japanese J Ophthalmol. 2002; 46(5): 577-580.
Gichigo N, Kariuki M, Kimani K. Survival among retinoblastoma patients at KNH, a retrospective audit., Nairobi. J Ophthalmol Eastern Central and Southern Africa. 2013; 17(1): 16 – 19.
Essuman V, Ntim-Amponsah CT, Akafo S, Renner L, Edusei L. Presentation of retinoblastoma at a paediatric eye clinic in Ghana. Ghana Med J. 2010; 44: 10-15.
Menon BS, Alagaratnam J, Juraida E, Mohamed M, Ibrahim H, Naing NN. Late presentation of retinoblastoma in Malaysia. Paediat Blood Cancer. 2009; 52(2). 215 – 217.
Kashyap S, Meel R, Pushker N, Sen S, Bakhshi S, Sreenivas V, et al. Clinical predictors of high risk histopathology in retinoblastoma. wileyonlinelibrary.com. Paediat Blood Cancer. 2011, DOI 10.1002/pbc.23239.
Butros LJ, Abramson DH, Dunkel IJ. Delayed diagnosis of retinoblastoma: analysis of degree, cause, and potential consequences. Pediatrics [Internet]. 2001; 109(3): e45–e45.