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A tool for planning retinoblastoma services in sub-Saharan Africa
Lindsay Hampejsková1, Covadonga Bascaran1, Marcia Zondervan1
1International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
Insights
This study developed an online tool to estimate human resource needs for managing retinoblastoma (RB), a childhood eye cancer, in sub-Saharan Africa. The tool aids in planning essential services to improve survival rates in low-resource settings.
Area of Science:
- Pediatric Oncology
- Global Health
- Health Resource Planning
Background:
- Cancer care is inadequate in low-middle income countries (LMICs), with significantly lower survival rates for children compared to high-income countries.
- Retinoblastoma (RB), an aggressive childhood eye cancer, has a low survival rate in sub-Saharan Africa (SSA) due to delayed diagnosis and treatment abandonment.
- Effective planning for human resources is crucial to address the disparity in cancer care outcomes.
Purpose of the Study:
- To develop an online tool to estimate the human resources required for managing retinoblastoma (RB) in sub-Saharan Africa (SSA).
- To provide a data-driven approach for healthcare planning and resource allocation for childhood eye cancer in LMICs.
Main Methods:
- An online tool was created with 19 modifiable fields and 23 estimates, utilizing routine demographic data.
- Key constant values included incidence frequency (1:17,000), familial cases (8%), unilateral RB (74%), extraocular disease (70%), and survival post-treatment (10%).
Main Results:
- An estimated 1,023 RB cases occur annually across eight SSA countries, with Nigeria and Zimbabwe having the highest and lowest case numbers, respectively.
- Over 41,000 patient visits are projected annually, requiring approximately 2,800 prosthetic eyes.
- The tool provides country-specific estimates for planning interventions and services.
Conclusions:
- Estimates are vital for planning medical services in data-scarce environments like SSA.
- Increased attention is needed from Ministries of Health to build multidisciplinary teams and establish integrated clinical practice guidelines for managing retinoblastoma.
- Implementing countrywide databases and standardized care protocols can improve outcomes for childhood eye cancer.
Background:
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.
Procedure:
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%.
Results:
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.
Conclusions:
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.
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