Challenges and Outcomes of Retinoblastoma Treatment in Ethiopia A Case of Jimma University Medical Center, Southwest Ethiopia.

Abstract

Background: Retinoblastoma, the most common intraocular malignancy in children, presents significant challenges globally, especially in low-resource settings like Ethiopia. This study aimed to assess the challenges and outcomes of retinoblastoma treatment at Jimma University Medical Center from October 2015 to September 2022.

Methods: A retrospective study was conducted to evaluate the treatment outcomes of retinoblastoma patients. Statistical analysis was performed using SPSS Version 26, with variables summarized as frequencies, percentages, means, or medians.

Results: A total of 43 children were treated from October 2015 to September 2022. The most common symptom recognized by caregivers was leucocoria (67.4%). Proptosis was the most frequent presenting symptom (53.5%), and delayed healthcare seeking was common. Diagnostic tools primarily included B-scan ultrasound (65.1%). Most children presented with advanced disease stages (Group D or E), requiring aggressive treatments such as intravenous chemotherapy (74.4%) and enucleation (23.8%). However, treatment adherence was poor, with high abandonment rates (55.8%) and incomplete chemotherapy cycles (81.3%). Metastasis occurred in 40% of patients, highlighting the aggressive nature of the disease. The mortality rate was 20.9%, mainly due to disease progression exacerbated by treatment interruptions. Challenges in follow-up and communication with remote patients further complicated outcomes assessment.

Conclusion: The treatment outcomes for retinoblastoma were suboptimal, affected by delayed presentation and inadequate adherence to treatment. This emphasizes the critical need for improved early detection programs, enhanced treatment adherence strategies, and strengthened healthcare infrastructure to mitigate the impact of retinoblastoma and improve treatment outcome in resource-limited settings like Ethiopia.