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Patterns of Retinoblastoma in Zimbabwe: 2000-2009
I Chitsike1, P Kuona, J Dzangare
1Department of Paediatrics and Child Health, University of Zimbabwe, College of Health Sciences P O Box A178, Avondale, Harare, Zimbabwe.
Insights
Retinoblastoma in Zimbabwean children presents late, with most cases diagnosed after age two. This pediatric cancer shows a male predominance and limited access to timely treatment, impacting outcomes.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Cancer Epidemiology
Background:
- Retinoblastoma is the most common primary intraocular malignancy in children.
- Early diagnosis and treatment are crucial for vision and survival.
- Understanding the epidemiological patterns in specific regions is vital for public health initiatives.
Purpose of the Study:
- To document the epidemiological patterns of retinoblastoma in children in Zimbabwe.
- To analyze the clinical presentation, diagnosis, and treatment of retinoblastoma cases.
- To identify challenges in managing retinoblastoma in a resource-limited setting.
Main Methods:
- Retrospective study design.
- Analysis of data from the Zimbabwe National Cancer Registry and the Paediatric Oncology Unit at Parirenyatwa Tertiary Hospital (2000-2009).
- Inclusion of data on diagnosis, age, gender, clinical presentation, time to diagnosis, and treatment modalities.
Main Results:
- 196 retinoblastoma cases were registered; 89% confirmed histologically.
- Median age at diagnosis was 24 months, with a male predominance (1.3:1).
- Common presentations included proptosis (65%) and leucocoria (26%), with a mean diagnostic delay of 7.7 months. Treatment included enucleation (61%), exenteration (37%), chemotherapy (63%), and radiotherapy (11%).
Conclusions:
- Retinoblastoma is the third most common childhood malignancy in Zimbabwe.
- The study highlights late presentation and limited access to therapy as significant challenges.
- Improved diagnostic and therapeutic strategies are needed to improve outcomes for pediatric retinoblastoma in Zimbabwe.
Objective:
To document the pattern of retinoblastoma in children in Zimbabwe for the period 2000-2009.
Design:
Retrospective study.
Methods:
Analysis of data from the Zimbabwe National Cancer registry and records of patients admitted to the Paediatric Oncology unit. Data collected from cancer registry were basis of diagnosis, age and gender. Data from the patients medical records included clinical presentation, time to diagnosis and treatment.
Settings:
The Zimbabwe National Cancer Registry and Paediatric Oncology Unit at Parirenyatwa Tertiary Hospital.
Results:
196 patients with retinoblastoma were registered at the cancer registry over the study period. The diagnosis was confirmed histologically on 89% of the cases and in 7% the diagnosis was based on clinical grounds. The age ranged from less than one month to 7 years with median age of 24 months. Males were 111 (56%) with male:female ratio of 1.3:1. Forty three patients (84%) had unilateral and 8 (16%) bilateral disease. Medical records were retrieved from only 54 /196 cases (27.5%). The commonest clinical presentation was proptosis 35/54 (65%). Leucocoria was present in 14/54 (26%). Time interval between first symptoms and diagnosis ranged from less than one month to 24 months with mean duration of 7.7 months (SD = 6.9). Enucleation was performed on 33/ 54 (61%), exenteration on 20/54 (37%) chemotherapy was given to 34/54 (63%) and only 6/54 (11%) received radiotherapy.
Conclusion:
Retinoblastoma is the third commonest registered malignancy of childhood in Zimbabwe, characaterised by late presentation and poor access to therapy.
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