ASSESSMENT OF AWARENESS, ATTITUDE AND PRACTICE TOWARDS OBSERVATION OF RETINOBLASTOMA AMONG MOTHERS OF UNDERFIVE CHILDREN IN NIGERIA

ASSESSMENT OF AWARENESS, ATTITUDE AND PRACTICE TOWARDS OBSERVATION OF RETINOBLASTOMA AMONG MOTHERS OF UNDERFIVE CHILDREN IN NIGERIA

Background of the Study

The eye is one of the five major sense organs of the body, which makes vision possible. Problems associated with early development of the eye results into diverse eye problems including retinoblastoma. Retinoblastoma (eye cancer) is a cancer of the eye that starts in the retina, the very back part of the eye (Boyd & Maturi, 2016). The retina is the inner layer of cells in the back of the eye. It is made up of special nerve cells that are sensitive to light. These light-sensing cells are connected to the brain by the optic nerve, which runs out the back of the eyeball. The pattern of light (image) that reaches the retina is sent through the optic nerve to an area of the brain called the visual cortex, allowing us to see. The eyes develop very early as babies grow in the womb. During the early stages of development, the eyes have cells called retinoblasts that divide into new cells and fill the retina. At a certain point, these cells stop dividing and develop into mature retinal cells. Rarely, something goes wrong with this process. Instead of maturing into special cells that detect light, some retinoblasts continue to divide and grow out of control, forming a cancer known as retinoblastoma. Retinoblastoma is the most common type of eye cancer in children of ages 0-5 years and represents 3% of all childhood malignancies. It is a cancer of the very young; two thirds of the cases are diagnosed before 2 years of age, and 95% before 5 years of age (American Academy of Ophthalmology (AAO), 2013). Retinoblastoma is a cancer of the very young and mostly found among underfive children, this cancer has another name that is ―eye cancer‖, the disease can affect people of any age but commonly affects children aged less than 5 years (American 2 Cancer Society (ACS), 2015). According to Broaddus, Topham and Singh (2009), the mean age-adjusted incidence of retinoblastoma in the United State of America was 11.8 per million children aged 0-4 years. They also confirmed that the incidence was similar to the rates reported in Europe. However, the incidence of retinoblastoma is not distributed equally around the world with 8000–9000 new cases recorded annually (AAO, 2013). It appears to be higher in Africa, India, and among children of Native American descent in the North American continent (Ward, DeSantis, Robbins, Kohler, & Jemal, 2014; Bunin, & Orjuela, 2015). Whether these geographical variations are due to ethnic or socioeconomic factors is not well known. However, the fact that even in industrialized countries an increased incidence of retinoblastoma is associated with poverty and low levels of maternal education (De Camargo, de Oliveira Ferreira, de Souza Reis, Ferman, de Oliveira Santos, and Pombo-de-Oliveira, 2011: FajardoGutierrez, Juarez-Ocana, Gonzalez-Miranda, 2007) proves a point that awareness is requisite to early detection of the disease. Awareness according to Merriam-Webstar Dictionary (2017) is having or showing realization, perception or knowledge of something. Therefore, awareness can be said to be knowledge. Zagzebski, (2017) stated that knowledge is a highly valued state in which a person is in cognitive contact with reality. Awareness in the context of this study is the knowledge of retinoblastoma, which is the ability of the subjects to identify the disease in their children or ability to recognize signs and symptoms of retinoblastoma in its early stage and form. In Nigeria today lack of proper awareness and mass media campaigns on evolving health issues is a major challenge to knowledge and awareness of evolving health issues. Cancers are a major cause of deaths in our society today, but major emphases are not made to help tackle the menace. Retinoblastoma is a rare and life-threatening condition, but when it is managed 3 optimally by a competent health team there is excellent prognosis for survival and good visual outcomes. But management of retinoblastoma continues to be a major challenge to health care providers as it is in most cases presented late in the healthcare centres, when eye salvage is not possible (Owoeye, Afolayan, & Ademola-Popoola, 2005). The ability to detect the disease while it is still in its earlier stage (intra-ocular) makes it possible for treatment and preservation of vision. Owoeye et al, (2005) reported that 65% of the cases died before completing the course of chemotherapy in Ilorin. Presumably this might be due to the poor awareness and attitudes towards health seeking which results to delays in reporting cases of retinoblastoma until it has spread to other parts of the eye

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