Figure 2: Improvement opportunities - a proposed chain of
initiatives based on the review of studies in the countries pointed in
the map (Jordan, India, Kenya, Lebanon, Brazil, Nigeria, Honduras,
Ethiopia, Peru) and multinational studies. Act 1: International
Partnership : Establishing partnerships with the teleconsultation of
specialists, mentoring programs, and financial aid to support the
development of local programs. Act 2: Nationally Coordinated
Programs: Implementing nationally coordinated programs for public
assistance, including centralization of care, financial aid from local
governments, and educational initiatives. Act 3: Education and
Awareness: Develop educational tools for the medical community and
general population to increase awareness of the disease, particularly
targeting populations at higher risk. Act 4: Screening Programs:Implementing screening programs focused on populations at higher risk,
while also incorporating periodic ocular health evaluation for all
children. Future considerations include the integration of smartphone
applications and algorithms to enhance screening accuracy. Act 5:
Genetic Services: Establishing cost-effective genetic screening
services to support early detection and diagnosis.
4.2. Limitations and other
challenges
Heterogeneity in study types and interventions prevented quantitative
analysis. No clinical trials on the subject were found. However, this
review emphasizes relevant interventions from observational studies,
suggesting their potential evaluation in experimental settings to
improve outcome confidence. However, numerous other barriers to early
diagnosis and treatment access, such as medical care abandonment,
diagnostic errors, referral delays, geographic distance from health
facilities, and challenges related to treatment toxicity were not
addressed here.
CONCLUSION
Most LMICs lack adequate diagnosis and treatment programs specifically
tailored for RB. It is crucial to identify the specific deficiencies and
gaps in care within each country to implement the suggested acts in a
customized manner. This study provides indirect evidence of
interventions that may contribute to improving survival rates and
preserving vision in patients with RB, but these findings should be
corroborated through appropriately designed studies.