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Pediatric Hydrocephalus in Ethiopia: Treatment Failures and Infections: A Hospital-Based, Retrospective Study

Tsegazeab Laeke1, Abenezer Tirsit1, Hagos Biluts1

  • 1Neurosurgery Unit, Addis Ababa University, School of Health Sciences, Addis Ababa, Ethiopia.

World Neurosurgery
|January 7, 2017
PubMed

Insights

Pediatric hydrocephalus treatment in Ethiopia shows high complication rates, particularly with ventriculoperitoneal (VP) shunts. Endoscopic third ventriculostomy (ETV) appears to be a more promising alternative, with decreasing failure rates observed.

Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Global Health

Background:

  • Pediatric hydrocephalus management in sub-Saharan Africa faces high complication rates.
  • Surgical interventions for hydrocephalus in Ethiopian children require analysis to improve outcomes.

Purpose of the Study:

  • To analyze the management of hydrocephalus in Ethiopian children.
  • To assess complication rates of surgical interventions for pediatric hydrocephalus.
  • To identify strategies for improving the quality of hydrocephalus treatment in Ethiopia.

Main Methods:

  • Retrospective cohort study conducted at a neurosurgical teaching hospital.
  • Analysis of two cohorts of pediatric patients over a 2.5-year period.
  • Inclusion of children with isolated hydrocephalus, meningomyelocele (MMC)-related hydrocephalus, or MMC without hydrocephalus.

Main Results:

  • 128 children (1 day to 5 years) were included; 113 had hydrocephalus.
  • Ventriculoperitoneal (VP) shunting was performed in 74.7% of patients, with a 23.4% shunt infection rate.
  • Reoperation was required in 52.4% of patients, primarily due to shunt failure; Endoscopic third ventriculostomy (ETV) failed in 58.3% of cases.

Conclusions:

  • Ventriculoperitoneal (VP) shunt insertions exhibit unacceptably high infection rates, necessitating stricter adherence to intraoperative guidelines.
  • Minimizing the number of surgeons performing VP shunts and avoiding them as primary treatment are recommended.
  • Endoscopic third ventriculostomy (ETV) shows potential as a better alternative, with observed decreasing failure rates suggesting its efficacy.
Abstract

Keywords:
ETVHydrocephalusManagementPrevalenceShunt infectionVP shunt

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