Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

Ido Didi Fabian^{1

2}, Andrew W Stacey³, Allen Foster⁴, Tero T Kivelä⁵, Francis L Munier⁶, Naama Keren-Froim⁷, Nir Gomel⁸, Nathalie Cassoux⁹, Mandeep S Sagoo¹⁰, M Ashwin Reddy¹¹, Lamis Al Harby¹¹, Marcia Zondervan⁴, Covadonga Bascaran⁴, Elhassan Abdallah¹², Shehu U Abdullahi¹³, Sahadatou Adamou Boubacar¹⁴, Dupe S Ademola-Popoola¹⁵, Adedayo Adio¹⁶, Ada E Aghaji¹⁷, Silvia Alarcón Portabella¹⁸, Amadou I Alfa Bio¹⁹, Amany M Ali²⁰, Donjeta B Alia²¹, Charlotta All-Eriksson²², Argentino A Almeida²³, Khalifa M Alsawidi²⁴, Romanzo Antonino²⁵, Nicholas J Astbury⁴, Rose Atsiaya²⁶, Julia Balaguer²⁷, Walentyna Balwierz²⁸, Honorio Barranco²⁷, Maja Beck Popovic²⁹, Sarra Benmiloud³⁰, Nissrine Bennani Guebessi³¹, Rokia C Berete³², Shelley J Biddulph³³, Eva M Biewald³⁴, Sharon Blum², Nadia Bobrova³⁵, Marianna Boehme³⁴, Norbert Bornfeld³⁴, Gabrielle C Bouda³⁶, Hédi Bouguila³⁷, Amaria Boumedane³⁸, Bénédicte G Brichard³⁹, Michael Capra L⁴⁰, Guilherme Castela⁴¹, Jaume Català-Mora⁴², Guillermo L Chantada⁴², Violeta S Chernodrinska⁴³, Faraja S Chiwanga⁴⁴, Krzysztof Cieslik⁴⁵, Codruta Comsa⁴⁶, Maria G Correa Llano⁴², Monika Csóka⁴⁷, Isac V Da Gama⁴⁸, Alan Davidson⁴⁹, Patrick De Potter³⁹, Laurence Desjardins⁵⁰, Monica D Dragomir⁴⁶, Magritha Du Bruyn⁵¹, Asmaa El Kettani³¹, Amal M Elbahi²⁴, Dina Elgalaly⁵², Alaa M Elhaddad⁵², Moawia M Ali Elhassan⁵³, Mahmoud M Elzembely²⁰, Vera A Essuman⁵⁴, Ted Grimbert A Evina⁵⁵, Oluyemi Fasina⁵⁶, Ana Fernández-Teijeiro⁵⁷, Moira Gandiwa⁵⁸, David García Aldana⁵⁹, Jennifer A Geel^{33

60}, Zelalem Gizachew⁶¹, Pernille A Gregersen⁶², Koffi M Guedenon⁶³, Theodora Hadjistilianou⁶⁴, Sadiq Hassan¹³, Stanislava Hederova⁶⁵, Laila Hessissen⁶⁶, Diriba F Hordofa⁶⁷, Marlies Hummlen⁶⁸, Kristina Husakova⁶⁵, Russo Ida²⁵, Vesna R Ilic⁶⁹, Helen Jenkinson⁷⁰, Theophile B Amani Kabesha⁷¹, Rolande L Kabore³⁶, Abubakar Kalinaki⁷², Noa Kapelushnik², Tamar Kardava⁷³, Pavlin Kroumov Kemilev⁴³, Tomas Kepak⁷⁴, Zaza Khotenashvili⁷³, Artur Klett⁷⁵, Jess Elio Kosh Komba Palet⁷⁶, Dalia Krivaitiene⁷⁷, Mariana Kruger⁷⁸, Alice Kyara⁴⁴, Eva S Lachmann⁷⁹, Slobodanka Latinović⁸⁰, Karin Lecuona⁸¹, Robert M Lukamba⁸², Livia Lumbroso⁵⁰, Lesia Lysytsia⁸³, Erika Maka⁴⁷, Mayuri Makan⁸⁴, Chatonda Manda⁵⁸, Nieves Martín Begue¹⁸, Ibrahim O Matende²⁶, Marchelo Matua⁸⁵, Ismail Mayet³³, Freddy B Mbumba⁸⁶, Aemero A Mengesha⁸⁷, Edoardo Midena⁸⁸, Furahini G Mndeme⁸⁹, Ahmed A Mohamedani⁹⁰, Annette C Moll⁹¹, Claude Moreira⁹², Mchikirwa S Msina⁸⁹, Gerald Msukwa⁵⁸, Kangwa I Muma⁹³, Gabriela Murgoi⁴⁶, Kareem O Musa⁹⁴, Hamzah Mustak⁸¹, Okwen M Muyen⁹⁵, Gita Naidu³³, Larisa Naumenko⁹⁶, Paule Aïda Ndoye Roth⁹⁷, Vladimir Neroev⁹⁸, Marina Nikitovic⁶⁹, Elizabeth D Nkanga⁹⁹, Henry Nkumbe⁵⁵, Mutale Nyaywa¹⁰⁰, Ghislaine Obono-Obiang¹⁰¹, Ngozi C Oguego¹⁷, Andrzej Olechowski⁴⁵, Alexander Hugo Oscar⁴³, Peter Osei-Bonsu¹⁰², Sally L Painter⁷⁰, Vivian Paintsil¹⁰², Luisa Paiva¹⁰³, Ruzanna Papyan¹⁰⁴, Raffaele Parrozzani⁸⁸, Manoj Parulekar⁷⁰, Katarzyna Pawinska-Wasikowska²⁸, Sanja Perić¹⁰⁵, Remezo Philbert¹⁰⁶, Pavel Pochop¹⁰⁷, Vladimir G Polyakov^{108

109}, Manca T Pompe¹¹⁰, Jonathan J Pons¹¹¹, Léa Raobela¹¹², Lorna A Renner¹¹³, David Reynders¹¹⁴, Dahiru Ribadu¹¹⁵, Mussagy M Riheia¹¹⁶, Petra Ritter-Sovinz¹¹⁷, Svetlana Saakyan⁹⁸, Azza Ma Said¹¹⁸, Sonsoles San Román Pacheco¹¹⁹, Trish A Scanlan⁴⁴, Judy Schoeman¹¹⁴, Stefan Seregard²², Sadik T Sherief⁶¹, Sidi Sidi Cheikh¹²⁰, Sónia Silva⁴¹, Tetyana Sorochynska³⁵, Grace Ssali¹²¹, Christina Stathopoulos⁶, Branka Stirn Kranjc¹¹⁰, David K Stones¹²², Karel Svojgr¹²³, Fatoumata Sylla¹²⁴, Gevorg Tamamyan¹⁰⁴, Alketa Tandili²¹, Bekim Tateshi¹²⁵, Tuyisabe Theophile¹²⁶, Fousseyni Traoré¹²⁷, Harba Tyau-Tyau¹²⁸, Ali B Umar¹³, Steen F Urbak¹²⁹, Tatiana L Ushakova^{108

109}, Sandra Valeina¹³⁰, Milo van Hoefen Wijsard⁹¹, Nevyana V Veleva-Krasteva⁴³, Maris Viksnins¹³⁰, Werner Wackernagel¹³¹, Keith Waddell⁸⁵, Patricia D Wade¹³², Amina H Wali Nigeria¹³³, Amelia Dc Wime¹⁰³, Charlotte Wolley Dod¹⁸, Jenny M Yanga¹³⁴, Vera A Yarovaya¹³⁵, Andrey A Yarovoy¹³⁵, Ekhtelbenina Zein¹³⁶, Shirley Sharabi¹³⁷, Katsiaryna Zhilyaeva⁹⁶, Othman Ao Ziko¹¹⁸, Richard Bowman¹³⁸

Affiliations

¹ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK didi@didifabian.com.
² The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.
³ Department of Ophthalmology, University of Washington, Seattle, WA, US.
⁴ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
⁵ Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland.
⁷ Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁸ Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁹ Institut curie, université de Paris medicine Paris V Descartes, Paris, France.
¹⁰ NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, UK.
¹¹ The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK.
¹² Ophthalmology Department of Rabat, Mohammed V university, Rabat, Morocco.
¹³ Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.
¹⁴ National Hospital of Niamey, Niamey, Niger.
¹⁵ University of Ilorin and University of IlorinTeaching Hospital, Ilorin, Kwara State, Nigeria.
¹⁶ Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
¹⁷ Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria.
¹⁸ Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain.
¹⁹ University of Parakou, Parakou, Benin.
²⁰ Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²¹ University Hospital Center 'Mother Theresa', Tirana, Albania.
²² St Erik Eye Hospital, Stockholn, Sweden.
²³ Beira Central Hospital, Beira, Mozambique.
²⁴ Tripoli Eye Hospital, Tripoli University, Tripoli, Libya.
²⁵ Bambino Gesù IRCCS Children's Hospital, Rome, Italy.
²⁶ Light House For Christ Eye Center, Mombasa, Kenya.
²⁷ Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
²⁸ Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland.
²⁹ Unit of Pediatric Hematology-Oncology, University Hospital CHUV, Lausanne, Switzerland.
³⁰ Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco.
³¹ Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco.
³² Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'ivoire.
³³ University of the Witwatersrand, Johannesburg, South Africa.
³⁴ University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany.
³⁵ The Filatov Institute of Eye diseases and Tissue Therapy, Odessa, Ukraine.
³⁶ Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso.
³⁷ Institut Hédi-Raïs d'Ophtalmologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisia.
³⁸ Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria.
³⁹ Cliniques Universitaires Saint-Luc, Brussel, Belgium.
⁴⁰ Our Lady's Children's Hospital, Dublin, Ireland.
⁴¹ Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal.
⁴² Hospital Sant Joan de Déu, Barcelona, Spain.
⁴³ Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria.
⁴⁴ Muhimbili National Hospital, Dar es Salaam, Tanzania.
⁴⁵ Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
⁴⁶ Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania.
⁴⁷ Semmelweis University Budapest, Budapest, Hungary.
⁴⁸ Quelimane central Hospital, Quelimane, Mozambique.
⁴⁹ Red Cross Children's War Memorial Hospital and the University of Cape Town, Cape Town, South Africa.
⁵⁰ Institut curie, Paris, France.
⁵¹ University of KwaZulu-Natal, Durban, South Africa.
⁵² Children's Cancer Hospital Egypt 57357, Cairo, Egypt.
⁵³ Oncology Department, National Cancer Institute, University of Gezira, Wadi Madani, Sudan.
⁵⁴ Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
⁵⁵ Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon.
⁵⁶ Department of Ophthalmology, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria.
⁵⁷ Hospital Universitario Virgen Macarena, Sevilla, Spain.
⁵⁸ Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi.
⁵⁹ Servicio Andaluz de Salud (SAS), Sevilla, Spain.
⁶⁰ Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
⁶¹ Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia.
⁶² Department of Clinical Genetics, and Center for Rare Disorders, Aarhus University Hopspital, Aarhus, Denmark.
⁶³ Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.
⁶⁴ Retinoblastoma referral center, University of Siena, Siena, Italy.
⁶⁵ University Childrens' Hospital, Bratislava, Slovakia.
⁶⁶ Pediatric Hematology and Oncology Department of Rabat - Mohammed V University, Rabat, Morocco.
⁶⁷ Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia.
⁶⁸ Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
⁶⁹ Institute for Oncology and Radiology, Belgrade, Serbia.
⁷⁰ Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
⁷¹ Bukavu Eye Clinic - Bukavu Official University, Bukavu, DRC.
⁷² Makerere University College of Health Sciences, Department of Ophthalmology, Kamplala, Uganda.
⁷³ Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia.
⁷⁴ University Hospital Brno, Masaryk University and ICRC/St. Anna University Hospital, Brno, Czech Republic.
⁷⁵ East Tallinn Central Hospital, Tallinn, Estonia.
⁷⁶ Oncologue Pédiatre Responsable d'Unité de Bangui, Bangui, Central African Republic.
⁷⁷ Chidren's Ophthalmology Department, Chidren's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania.
⁷⁸ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
⁷⁹ University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁸⁰ Clinical Center Of Vojvodina - University Eye Clinic, Eye Research Foundation Vidar - Latinović, Novi Sad, Serbia.
⁸¹ Division of Ophthalmology, University of Cape Town, Cape Town, South Africa.
⁸² University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, DRC.
⁸³ The Okhmatdyt National Children's Hospital, Kiev, Ukraine.
⁸⁴ Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe.
⁸⁵ Ruharo Eye Hospital, Mbarara, Uganda.
⁸⁶ Botswana Government - Scottish Livingstone Hospital, Molepolole, Botswana.
⁸⁷ Department of Ophthalmology, Jimma University, Jimma, Ethiopia.
⁸⁸ Department of Ophthalmology, University of Padova, Padova, Italy.
⁸⁹ Kilimanjaro Christian Medical Center, Moshi, Tanzania.
⁹⁰ Pathology Department, Faculty of Medicine, University of Gezira, Wadi Madani, Sudan.
⁹¹ Department of Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands.
⁹² Service d'oncologie pédiatrique de l'hôpital Aristide le Dantec, Dakar, Senegal.
⁹³ Ministry of Health, Lusaka, Zambia.
⁹⁴ Department of Ophthalmology, Lagos University Teaching Hospital/College of Medicine of the University of Lagos, Lagos, Nigeria.
⁹⁵ Abii Specialists Hospital, Bamenda, Cameroon.
⁹⁶ N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus.
⁹⁷ Cheikh Anta DIOP University of Dakar, Le Dantec Hospital, Dakar, Senegal.
⁹⁸ Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia.
⁹⁹ Calabar Children's Eye Center, Department of Ophthalmology University of Calabar Teaching Hospital Calabar Cross River State, Nigeria.
¹⁰⁰ Arthur Davison Children's Hospital, Ndola, Zambia.
¹⁰¹ Chu Angondje Cancerologie, Libreville, Gabon.
¹⁰² Komfo Anokye Teaching Hospital, Kumasi, Ghana.
¹⁰³ National Ophthalmological Institute of Angola, Luanda, Angola.
¹⁰⁴ Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia.
¹⁰⁵ University Hospital Center Zagreb, Zagreb, Croatia.
¹⁰⁶ Center Hospitaliere Universitaire de Kamenge, Bujumbura, Burundi.
¹⁰⁷ Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
¹⁰⁸ Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.
¹⁰⁹ Medical Academy of Postgraduate Education, Moscow, Russia.
¹¹⁰ Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia.
¹¹¹ Good Shepherd Hospital, Siteki, Swaziland.
¹¹² Center Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.
¹¹³ University of Ghana School of Medicine and Dentistry, Korle Bu Teaching Hospital, Accra, Ghana.
¹¹⁴ University of Pretoria, Pretoria, South Africa.
¹¹⁵ Federal Medical Center, Yola, Nigeria.
¹¹⁶ Nampula central hospital, Nampula, Mozambique.
¹¹⁷ Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria.
¹¹⁸ Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹¹⁹ Pediatric Hemato-Oncology, Hospital Universitario Infantil La Paz, Madrid, Spain.
¹²⁰ Ophthalmology department, Nouakchott Medical University, Nouakchott, Mauritania.
¹²¹ Mulago National Referral and Teaching Hospital, Kamplala, Uganda.
¹²² Department of Paediatrics and Child Health, University of the Free Sate, Bloemfontein, South Africa.
¹²³ Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
¹²⁴ Africa Institute of Tropical Ophtalmology, Bamako, Mali.
¹²⁵ University Eye Clinic, Skopje, Macedonia.
¹²⁶ Kabgayi Eye Unit, Gitarama, Rwanda.
¹²⁷ Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali.
¹²⁸ Université Adam Barka, Adam Barka, Chad.
¹²⁹ Department of ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
¹³⁰ Children's Clinical University Hospital, Riga, Latvia.
¹³¹ Department of Ophthalmology, Medical University Graz, Graz, Austria.
¹³² Jos University Teaching Hospital, Jos, Nigeria.
¹³³ National Eye Center Kaduna, Kaduna, Nigeria.
¹³⁴ Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, DRC.
¹³⁵ S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia.
¹³⁶ Assistante Hospitalo - Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania.
¹³⁷ Radiology Department, Sheba Medical Center, Ramat-Gan, Israel.
¹³⁸ Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK.

PMID: 32933936
DOI: 10.1136/bjophthalmol-2020-316613

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

Ido Didi Fabian et al. Br J Ophthalmol. 2021 Oct.

. 2021 Oct;105(10):1435-1443.

doi: 10.1136/bjophthalmol-2020-316613. Epub 2020 Sep 15.

Authors

Affiliations

¹ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK didi@didifabian.com.
² The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel.
³ Department of Ophthalmology, University of Washington, Seattle, WA, US.
⁴ International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK.
⁵ Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
⁶ Jules-Gonin Eye Hospital, Fondation Asile de Aveugles, University of Lausanne, Lausanne, Switzerland.
⁷ Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁸ Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
⁹ Institut curie, université de Paris medicine Paris V Descartes, Paris, France.
¹⁰ NIHR Biomedical Research Center for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology and London Retinoblastoma Service, Royal London Hospital, London, UK.
¹¹ The Royal London Hospital, Barts Health NHS Trust, and Moorfields Eye Hospital NHS Foundation Trust, London, UK.
¹² Ophthalmology Department of Rabat, Mohammed V university, Rabat, Morocco.
¹³ Bayero University, Aminu Kano Teaching Hospital, Kano, Nigeria.
¹⁴ National Hospital of Niamey, Niamey, Niger.
¹⁵ University of Ilorin and University of IlorinTeaching Hospital, Ilorin, Kwara State, Nigeria.
¹⁶ Department of Ophthalmology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
¹⁷ Department of Ophthalmology, College of Medicine, University of Nigeria, Enugu, Nigeria.
¹⁸ Department of Pediatric Ophthalmology, Hospital Vall d'Hebron, Barcelona, Spain.
¹⁹ University of Parakou, Parakou, Benin.
²⁰ Pediatric Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.
²¹ University Hospital Center 'Mother Theresa', Tirana, Albania.
²² St Erik Eye Hospital, Stockholn, Sweden.
²³ Beira Central Hospital, Beira, Mozambique.
²⁴ Tripoli Eye Hospital, Tripoli University, Tripoli, Libya.
²⁵ Bambino Gesù IRCCS Children's Hospital, Rome, Italy.
²⁶ Light House For Christ Eye Center, Mombasa, Kenya.
²⁷ Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
²⁸ Institute of Pediatrics, Jagiellonian University Medical College, Childrens University Hospital of Krakow, Krakow, Poland.
²⁹ Unit of Pediatric Hematology-Oncology, University Hospital CHUV, Lausanne, Switzerland.
³⁰ Department of Pediatric Oncology, University Hassan II Fès, Fez, Morocco.
³¹ Center Hospitalier et Universitaire Ibn Rochd, Casablanca, Morocco.
³² Ophthalmologic Department of the Teaching Hospital of Treichville, Abidjan, Côte d'ivoire.
³³ University of the Witwatersrand, Johannesburg, South Africa.
³⁴ University Hospital Essen, Department of Ophthalmology, University Duisburg-Essen, Essen, Germany.
³⁵ The Filatov Institute of Eye diseases and Tissue Therapy, Odessa, Ukraine.
³⁶ Center Hospitalier Universitaire Yalgado Ouédraogo de Ouagadougou, Ouagadougou, Burkina Faso.
³⁷ Institut Hédi-Raïs d'Ophtalmologie de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisia.
³⁸ Etablissement Hospitalière Spécialise Emir Abdelkader CEA Service d'Oncologie Pédiatrique, Oran, Algeria.
³⁹ Cliniques Universitaires Saint-Luc, Brussel, Belgium.
⁴⁰ Our Lady's Children's Hospital, Dublin, Ireland.
⁴¹ Centro Hospital Universitário de Coimbra, University of Coimbra, Coimbra, Portugal.
⁴² Hospital Sant Joan de Déu, Barcelona, Spain.
⁴³ Eye Clinic, University Hospital 'Alexandrovska', Department of Ophthalmology, Medical University, Sofia, Bulgaria.
⁴⁴ Muhimbili National Hospital, Dar es Salaam, Tanzania.
⁴⁵ Department of Ophthalmology, The Children's Memorial Health Institute, Warsaw, Poland.
⁴⁶ Oncology Institute 'Prof. Dr. Al. Trestioreanu' Bucharest, Romania.
⁴⁷ Semmelweis University Budapest, Budapest, Hungary.
⁴⁸ Quelimane central Hospital, Quelimane, Mozambique.
⁴⁹ Red Cross Children's War Memorial Hospital and the University of Cape Town, Cape Town, South Africa.
⁵⁰ Institut curie, Paris, France.
⁵¹ University of KwaZulu-Natal, Durban, South Africa.
⁵² Children's Cancer Hospital Egypt 57357, Cairo, Egypt.
⁵³ Oncology Department, National Cancer Institute, University of Gezira, Wadi Madani, Sudan.
⁵⁴ Ophthalmology Unit, Department of Surgery, School of Medicine and Dentistry, University of Ghana, Accra, Ghana.
⁵⁵ Magrabi ICO Cameroon Eye Institute, Yaounde, Cameroon.
⁵⁶ Department of Ophthalmology, University College Hospital/University of Ibadan, Ibadan, Oyo State, Nigeria.
⁵⁷ Hospital Universitario Virgen Macarena, Sevilla, Spain.
⁵⁸ Lions Sight First Eye Hospital, Queen Elizabeth Central Hospital, Blantyre, Malawi.
⁵⁹ Servicio Andaluz de Salud (SAS), Sevilla, Spain.
⁶⁰ Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.
⁶¹ Addis Ababa University, School of Medicine, Department of Ophthalmology, Addis Ababa, Ethiopia.
⁶² Department of Clinical Genetics, and Center for Rare Disorders, Aarhus University Hopspital, Aarhus, Denmark.
⁶³ Département de Pédiatrie, CHU Sylvanus Olympio, Université de Lomé, Lomé, Togo.
⁶⁴ Retinoblastoma referral center, University of Siena, Siena, Italy.
⁶⁵ University Childrens' Hospital, Bratislava, Slovakia.
⁶⁶ Pediatric Hematology and Oncology Department of Rabat - Mohammed V University, Rabat, Morocco.
⁶⁷ Department of Pediatrics and Child Health, Jimma University Medical Center, Jimma, Ethiopia.
⁶⁸ Department of Ophthalmology, Oslo University Hospital, Oslo, Norway.
⁶⁹ Institute for Oncology and Radiology, Belgrade, Serbia.
⁷⁰ Birmingham Children's Hospital Eye Department, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.
⁷¹ Bukavu Eye Clinic - Bukavu Official University, Bukavu, DRC.
⁷² Makerere University College of Health Sciences, Department of Ophthalmology, Kamplala, Uganda.
⁷³ Ophthalmology Department, Central Children's Hospital of Georgia, Tbilisi, Georgia.
⁷⁴ University Hospital Brno, Masaryk University and ICRC/St. Anna University Hospital, Brno, Czech Republic.
⁷⁵ East Tallinn Central Hospital, Tallinn, Estonia.
⁷⁶ Oncologue Pédiatre Responsable d'Unité de Bangui, Bangui, Central African Republic.
⁷⁷ Chidren's Ophthalmology Department, Chidren's Hospital of Vilnius, University Hospital Santaros Clinic, Vilnius, Lithuania.
⁷⁸ Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
⁷⁹ University Hospital Hamburg-Eppendorf, Hamburg, Germany.
⁸⁰ Clinical Center Of Vojvodina - University Eye Clinic, Eye Research Foundation Vidar - Latinović, Novi Sad, Serbia.
⁸¹ Division of Ophthalmology, University of Cape Town, Cape Town, South Africa.
⁸² University Clinics of Lubumbashi, University of Lubumbashi, Lubumbashi, DRC.
⁸³ The Okhmatdyt National Children's Hospital, Kiev, Ukraine.
⁸⁴ Sekuru Kaguvi Eye Unit, Parirenyatwa Group of Hospitals, Harare, Zimbabwe.
⁸⁵ Ruharo Eye Hospital, Mbarara, Uganda.
⁸⁶ Botswana Government - Scottish Livingstone Hospital, Molepolole, Botswana.
⁸⁷ Department of Ophthalmology, Jimma University, Jimma, Ethiopia.
⁸⁸ Department of Ophthalmology, University of Padova, Padova, Italy.
⁸⁹ Kilimanjaro Christian Medical Center, Moshi, Tanzania.
⁹⁰ Pathology Department, Faculty of Medicine, University of Gezira, Wadi Madani, Sudan.
⁹¹ Department of Ophthalmology, Amsterdam UMC, Amsterdam, Netherlands.
⁹² Service d'oncologie pédiatrique de l'hôpital Aristide le Dantec, Dakar, Senegal.
⁹³ Ministry of Health, Lusaka, Zambia.
⁹⁴ Department of Ophthalmology, Lagos University Teaching Hospital/College of Medicine of the University of Lagos, Lagos, Nigeria.
⁹⁵ Abii Specialists Hospital, Bamenda, Cameroon.
⁹⁶ N.N. Alexandrov National Cancer Center of Belarus, Minsk, Belarus.
⁹⁷ Cheikh Anta DIOP University of Dakar, Le Dantec Hospital, Dakar, Senegal.
⁹⁸ Moscow Helmholtz Research Institute of Eye Diseases, Moscow, Russia.
⁹⁹ Calabar Children's Eye Center, Department of Ophthalmology University of Calabar Teaching Hospital Calabar Cross River State, Nigeria.
¹⁰⁰ Arthur Davison Children's Hospital, Ndola, Zambia.
¹⁰¹ Chu Angondje Cancerologie, Libreville, Gabon.
¹⁰² Komfo Anokye Teaching Hospital, Kumasi, Ghana.
¹⁰³ National Ophthalmological Institute of Angola, Luanda, Angola.
¹⁰⁴ Yerevan State Medical University, Department of Oncology and Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after R.H. Yeolyan, Yerevan, Armenia.
¹⁰⁵ University Hospital Center Zagreb, Zagreb, Croatia.
¹⁰⁶ Center Hospitaliere Universitaire de Kamenge, Bujumbura, Burundi.
¹⁰⁷ Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
¹⁰⁸ Head and Neck Tumors Department, SRI of Pediatric Oncology and Hematology of N.N. Blokhin National Medical Research Center of Oncology of Russian Federation, Moscow, Russian Federation.
¹⁰⁹ Medical Academy of Postgraduate Education, Moscow, Russia.
¹¹⁰ Univ. Medical Center Ljubljana, Univ.Eye Hospital Ljubljana, Ljubljana, Slovenia.
¹¹¹ Good Shepherd Hospital, Siteki, Swaziland.
¹¹² Center Hospitalier Universitaire Joseph Ravoahangy Andrianavalona, Antananarivo, Madagascar.
¹¹³ University of Ghana School of Medicine and Dentistry, Korle Bu Teaching Hospital, Accra, Ghana.
¹¹⁴ University of Pretoria, Pretoria, South Africa.
¹¹⁵ Federal Medical Center, Yola, Nigeria.
¹¹⁶ Nampula central hospital, Nampula, Mozambique.
¹¹⁷ Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology/Oncology, Medical University of Graz, Graz, Austria.
¹¹⁸ Ophthalmology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
¹¹⁹ Pediatric Hemato-Oncology, Hospital Universitario Infantil La Paz, Madrid, Spain.
¹²⁰ Ophthalmology department, Nouakchott Medical University, Nouakchott, Mauritania.
¹²¹ Mulago National Referral and Teaching Hospital, Kamplala, Uganda.
¹²² Department of Paediatrics and Child Health, University of the Free Sate, Bloemfontein, South Africa.
¹²³ Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
¹²⁴ Africa Institute of Tropical Ophtalmology, Bamako, Mali.
¹²⁵ University Eye Clinic, Skopje, Macedonia.
¹²⁶ Kabgayi Eye Unit, Gitarama, Rwanda.
¹²⁷ Pediatric Oncology Service, Gabriel Toure Hospital, Bamako, Mali.
¹²⁸ Université Adam Barka, Adam Barka, Chad.
¹²⁹ Department of ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
¹³⁰ Children's Clinical University Hospital, Riga, Latvia.
¹³¹ Department of Ophthalmology, Medical University Graz, Graz, Austria.
¹³² Jos University Teaching Hospital, Jos, Nigeria.
¹³³ National Eye Center Kaduna, Kaduna, Nigeria.
¹³⁴ Service d'Ophtalmologie, Cliniques Universitaires de Kinshasa, Université de Kinshasa, Kinshasa, DRC.
¹³⁵ S.Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia.
¹³⁶ Assistante Hospitalo - Universitaire, Faculte de Medecine de Nouakchott Medecin Oncopediatre, Center National d'Oncologie, Nouakchott, Mauritania.
¹³⁷ Radiology Department, Sheba Medical Center, Ramat-Gan, Israel.
¹³⁸ Ophthalmology Department, Great Ormond Street Children's Hospital, London, UK.

PMID: 32933936
DOI: 10.1136/bjophthalmol-2020-316613

Abstract

Background: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe.

Methods: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries.

Results: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease.

Conclusions: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral.

Keywords: Epidemiology; Neoplasia.

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Competing interests: None declared.

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Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

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Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

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Abstract

Conflict of interest statement

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