TY - JOUR T1 - Infant hydrocephalus in sub-Saharan Africa: Impact of perioperative care in the Zanzibar archipelago JO - Neurocirugía (English edition) T2 - AU - Moreno Oliveras,Luis AU - Llácer Ortega,José Luis AU - Leidinger,Andreas AU - Haji,Mohamed Ali AU - Chisbert Genovés,María Pilar AU - Piquer Belloch,José SN - 25298496 M3 - 10.1016/j.neucie.2020.01.001 DO - 10.1016/j.neucie.2020.01.001 UR - https://www.revistaneurocirugia.com/en-infant-hydrocephalus-in-sub-saharan-africa-articulo-S2529849620300113 AB - IntroductionChild hydrocephalus in low- and middle-income countries represents one of the most sensitive ethical and health problems facing international health development. The most optimistic estimates indicate that 200,000 newborns annually will develop hydrocephalus or be born with a neural tube defect in East, Central and South Africa (ECSA). It is estimated that less than 10% of these children will be operated by ventriculoperitoneal shunts, and in general in poor quality conditions or with a very high complication rate. ObjectiveTo describe the general characteristics, epidemiology and demographic data of childhood hydrocephalus of patients treated at the NED Institute in the Zanzibar archipelago, and assess the clinical details and medium-term results of the impact of the set-up nursing care. Material and methodsThis is a descriptive and analytical observational study of a retrospective nature, in patients diagnosed and treated with childhood hydrocephalus, in the period from September 2016 to September 2018. With the implementation of a series of perioperative nursing protocols in these patients, the results obtained were described and analysed. ResultsA total of 96 patients were treated for childhood hydrocephalus. 51% (n=49) of these patients were male, with a mean age of 9.25 months. All the mothers of the patients were monitored during pregnancy, but only 8% were treated with folic acid during pregnancy. 81% of children were born through vaginal delivery or uncomplicated spontaneous delivery. Regarding the aetiology, 27.1% of treated hydrocephalus was associated with an infectious cause and 35.4% with an unknown cause. 67 ventriculoperitoneal shunt surgery and 15 endoscopic ventriculostomies were performed. The complication rate was 23.17%. ConclusionsThe results of this research indicate that childhood hydrocephalus in Zanzibar has aetiology, evolution and complications that are similar to or less than those described to date in East Africa. Implementing a series of perioperative protocols and standardised nursing care positively influences the results obtained. Currently, the Mnazi Mmoja Surgical NED Institute is one of the few centres in East Africa with an exhaustive record of healthcare activity and is the first health centre that offers further training to nurses. ER -