Childhood hydrocephalus in low- and middle-income countries represents one of the most conflicting ethical and health problems facing health development at the international level.
The most optimistic estimates indicate that 200,000 born 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 on by ventriculoperitoneal shunts and, in general, in poor quality conditions or with a very high rate of complications.
The general characteristics, epidemiology, and demographic data of childhood hydrocephalus of patients treated at the NED Institute in the Zanzibar archipelago are studied within the R&D work promoted by the NED Foundation, and the clinical details and the medium-term results of the impact of implanted nursing care.
This is a retrospective descriptive and analytical observational study, in patients diagnosed and treated for childhood hydrocephalus, in the period between September 2016 and September 2018. With the implementation of a series of perioperative nursing protocols in these patients, the results obtained were described and analyzed.
A total of 96 patients were treated for childhood hydrocephalus. 51% (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% of them were treated with folic acid during their pregnancy. 81% of children were born through vaginal delivery or spontaneous uncomplicated delivery. Regarding the etiology, 27.1% of the hydrocephalus treated was associated with an infectious cause and 35.4% with an unknown cause. 67 ventriculoperitoneal bypass surgeries and 15 endoscopic ventriculostomies were performed. The complication rate was 23.17%.
The results of this research indicate that childhood hydrocephalus in Zanzibar has an aetiology, evolution and complications that are similar or less than those described to date in East Africa.
El hecho de implantar una serie de protocolos perioperatorios y cuidados estandarizados de enfermería influyen positivamente en los resultados obtenidos.
The fact of implementing a series of perioperative protocols and standardized nursing care positively influence the results obtained.
Currently, the Mnazi Mmoja Surgical NED Institute is one of the few centers in East Africa with a comprehensive record of healthcare activity and the first healthcare facility to offer continuing education to nursing staff.
A project developed with the aim of teaching Neuroendoscopy for the treatment of Hydrocephalus in children in the 11 countries of Central and East Africa: Ethiopia, Kenya, Uganda, Tanzania, Rwanda, Zambia, Zimbabwe, Malawi, Mozambique, Mauritius and the Seychelles. One of the top priorities is to consolidate and extend the project to other countries in the region that wish to do so
The goal is to train native neurosurgeons and nurses in the treatment of hydrocephalus by Neuroendoscopy. A hugely attractive alternative cures more than 70% of the cases without the need of a shunt. Thousands of people can be operated on at no cost, when donating an endoscope, (around the price of 15 shunts), with better results and fewer complications. In addition, if the intervention is effective the patient does not need medical monitoring. The child is cured.
Our message: providing means for any child has the opportunity to be treated by neuroendoscopy.