INTRODUCTION
Retinoblastoma is the most common intraocular cancer among childhood cancers. Its global incidence is estimated at 9,000 new cases per year, which corresponds to one case in 15,000 births; most in low-income countries1.
Retinoblastoma is cured in more than 95% of cases in high income countries2. However, in most low-income countries, the prognosis is still bleak with high mortality reaching 95% in some countries3. The reasons for this disparate and disastrous situation include late diagnosis and treatment, refusal and abandonment of treatment, as well as poor health infrastructures3,4. The abandonment rate of childhood cancer treatment is highest in low-income countries5. In addition, the retinoblastoma dropout rate in low- and middle-income countries is generally described as between 5% and 40%, respectively6. In most of these countries, the rate of enucleation refusal varies from 1 to 50% 7, and the rate of loss of follow-up after treatment varies from 10 to 75%8-12. This contributes to the high mortality rates of retinoblastoma.
The rates and factors associated with abandonment and refusal of treatment for retinoblastoma are poorly documented in sub-Saharan Africa5,13. Therefore, it is necessary to identify the factors related to this phenomenon to work to overcome them and draw lessons for other countries in sub-Saharan Africa. The objectives of this study were to determine: 1) the rate of refusal and abandonment of treatment for retinoblastoma, and 2) the factors associated with adherence to treatment for retinoblastoma in the Ivory Coast and the DRC.