Adherence to the Treatment of Retinoblastoma in the Ivory Coast and the
Democratic Republic of Congo: A retrospective cohort study
Background: In developed countries, retinoblastoma is curable
in more than 95% of cases, whereas in low-income countries, mortality
remains high, especially when the diagnosis is made late or the
treatment is discontinued. The aim of this work was to determine the
factors associated with adherence to the treatment of retinoblastoma in
the Ivory Coast and the Democratic Republic of Congo (DRC).
Procedure: A retrospective cohort study was carried out. Data
were collected from patient folders and follow-up records of parents.
Results: A total of 175 children with retinoblastoma were
registered from January 2013 to December 2015. Seventy-six children
(43%) were 5 years old and above. Care costs were covered by families
in 86.9% of cases. Chemotherapy refusal was recorded in 39 cases
(22.3%), and enucleation refusal was recorded in 79 cases (45.1%).
After 36 months of follow-up, we recorded 16.6% deaths, 27.4%
treatment dropouts, and 18.3% loss to follow-up after treatment. The
commonest cause for enucleation refusal was fear of infirmity, while
chemotherapy refusal and absconding treatment were due to financial
constraints. Conclusion: Poor adherence to retinoblastoma
management was due to financial constraints, and a lack of knowledge of
the disease and its treatment. Family psychosocial support is needed to
improve this condition.