Treating Pediatric Hydrocephalus at the Neurosurgery Education and Development Institute: The Reality in the Zanzibar Archipelago, Tanzania
Por:
Leidinger A, Piquer J, Kim EE, Nahonda H, Qureshi MM and Young PH
Publicada:
1 sep 2018
Resumen:
BACKGROUND: Pediatric hydrocephalus is a health burden for East African countries, with an estimated incidence of 6000 new cases per year. The objective of this study is to describe the epidemiology and surgical outcomes of patients treated for pediatric hydrocephalus in the single neurosurgical center of Zanzibar.
METHODS: From December 2016 to December 2017, we prospectively collected data on all patients admitted with the diagnosis of hydrocephalus. Information was gathered regarding demographics, maternal health, preoperative imaging, surgical procedures, and postsurgical complications.
RESULTS: We collected data on 63 patients. Average age was 203 days, and gender was 49.2% female and 50.8% male. All mothers of patients attended an antenatal clinic for routine screening during pregnancy. Folic acid prophylaxis was used by 9.5% of the mothers during pregnancy. At the first visit, 46.0% of patients presented with signs of infection, 20.6% with congenital abnormalities, and 20.6% with seizures. Regarding etiology of hydrocephalus, 22.2% of all cases were uncertain; 20.6% were associated with neural tube defects; 39.7% were post-infectious hydrocephalus; 3.2% were aqueduct stenosis; 4.8% were associated with brain tumor; and 9.6% were malformative. We performed 7 endoscopic third ventriculostomies and placed 40 ventriculoperitoneal shunts. The complication rate at follow-up was 12.5%.
CONCLUSIONS: It seems that hydrocephalus in Zanzibar has similar causes, progression, and complication rates to previous reports from other African hospitals. Further studies of postinfectious hydrocephalus need to be conducted because recent findings suggest that it is a potentially preventable cause of the disease.
Filiaciones:
Leidinger A:
Neurosurgery Education and Development (NED) Foundation, Valencia, Spain
Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Stonetown, Tanzania
:
Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Stonetown, Tanzania
Hospital Universitario de la Ribera, Alzira (Valencia), Spain
Kim EE:
Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Stonetown, Tanzania
Nahonda H:
Neurosurgery Education and Development (NED) Institute, Mnazi Mmoja Hospital, Stonetown, Tanzania
Qureshi MM:
Aga Khan University, Nairobi, Kenya
Young PH:
Section of Neurosurgery, Department of Surgery, St. Louis University, St. Louis, Missouri, USA
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