NEUROENDOSCOPY AND HYDROCEPHALY IN EAST AFRICA
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.