Retinoblastom in Malawi

TY - JOUR

T1 - Retinoblastom in Malawi

T2 - Warum zu späte Einweisung?

AU - Schulze Schwering, M

AU - Gandiwa, M

AU - Msukwa, G

AU - Spitzer, M

AU - Kalua, K

AU - Molyneux, E M

PY - 2014/12

Y1 - 2014/12

N2 - BACKGROUND: A total of 82 % of stationary admissions with the diagnosis of retinoblastoma (2009-2011) to the tertiary ophthalmology unit in Blantyre, Malawi (n = 58) presented with advanced stage disease.PATIENTS AND METHODS: In another study in 2012 we sought to identify why children mostly presented in advanced stages of disease and whether the delay was unique to children with cancer. In-depth interviews (IDI) were conducted at the hospital with 40 parents or guardians of children with retinoblastoma, congenital cataract, congenital glaucoma and corneal perforation (10 each).RESULTS: Most delays and delayed admissions occurred at the family (27.5 %, 11 out of 40) and primary health centre levels (30.0 %, 12 out of 40). Lack of money for transport caused delays (15.0 %, 6 out of 40) at all care levels. In contrast, children with painful conditions presented to a health facility within 24 h of onset without any complaints about lack of money for transport.CONCLUSION: Education about retinoblastoma and other non-painful eye diseases could be improved by a poster campaign to both parents and professionals at all medical healthcare levels. Transport for such cases between the various healthcare centers should be provided free of charge. There is room for improvement in initial diagnosis, referral and management within the healthcare service in the tertiary sector.

AB - BACKGROUND: A total of 82 % of stationary admissions with the diagnosis of retinoblastoma (2009-2011) to the tertiary ophthalmology unit in Blantyre, Malawi (n = 58) presented with advanced stage disease.PATIENTS AND METHODS: In another study in 2012 we sought to identify why children mostly presented in advanced stages of disease and whether the delay was unique to children with cancer. In-depth interviews (IDI) were conducted at the hospital with 40 parents or guardians of children with retinoblastoma, congenital cataract, congenital glaucoma and corneal perforation (10 each).RESULTS: Most delays and delayed admissions occurred at the family (27.5 %, 11 out of 40) and primary health centre levels (30.0 %, 12 out of 40). Lack of money for transport caused delays (15.0 %, 6 out of 40) at all care levels. In contrast, children with painful conditions presented to a health facility within 24 h of onset without any complaints about lack of money for transport.CONCLUSION: Education about retinoblastoma and other non-painful eye diseases could be improved by a poster campaign to both parents and professionals at all medical healthcare levels. Transport for such cases between the various healthcare centers should be provided free of charge. There is room for improvement in initial diagnosis, referral and management within the healthcare service in the tertiary sector.

KW - Adolescent

KW - Child

KW - Comorbidity

KW - Early Diagnosis

KW - Eye Pain

KW - Female

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Malawi

KW - Male

KW - Medical Oncology

KW - Ophthalmology

KW - Patient Admission

KW - Prevalence

KW - Retinal Neoplasms

KW - Retinoblastoma

KW - Risk Assessment

KW - Socioeconomic Factors

KW - Transportation

KW - Utilization Review

KW - English Abstract

KW - Journal Article

U2 - 10.1007/s00347-014-3117-x

DO - 10.1007/s00347-014-3117-x

M3 - SCORING: Zeitschriftenaufsatz

C2 - 25278348

VL - 111

SP - 1189

EP - 1193

JO - OPHTHALMOLOGE

JF - OPHTHALMOLOGE

SN - 0941-293X

IS - 12

ER -