Epidemiology of hydrocephalus in Brazil

Dutra, Maurício; Silva, Stephanya Covas da; Beggiora, Pâmella da Silva; Santos, Marcelo Volpon; Machado, Hélio Rubens; Lopes, Luíza da Silva

doi:10.1016/j.jped.2022.10.008

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…Hydrocephalus presents formidable medical challenges in developing countries due to high birth rates and limited access to medical resources. According to statistics, in Brazil, hydrocephalus causes the death of 1.5 out of every 100,000 newborns [ 29 ]. In Africa, the prevalence of CH can reach as high as 0.0145% [ 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

Zhang,

Hu,

Wang

2024

Neurochem Res

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The brain’s ventricles are filled with a colorless fluid known as cerebrospinal fluid (CSF). When there is an excessive accumulation of CSF in the ventricles, it can result in high intracranial pressure, ventricular enlargement, and compression of the surrounding brain tissue, leading to potential damage. This condition is referred to as hydrocephalus. Hydrocephalus is classified into two categories: congenital and acquired. Congenital hydrocephalus (CH) poses significant challenges for affected children and their families, particularly in resource-poor countries. Recognizing the psychological and economic impacts is crucial for developing interventions and support systems that can help alleviate the distress and burden faced by these families. As our understanding of CSF production and circulation improves, we are gaining clearer insights into the causes of CH. In this article, we will summarize the current knowledge regarding CSF circulation pathways and the underlying causes of CH. The main causes of CH include abnormalities in the FoxJ1 pathway of ventricular cilia, dysfunctions in the choroid plexus transporter Na+-K+-2Cl- contransporter isoform 1, developmental abnormalities in the cerebral cortex, and structural abnormalities within the brain. Understanding the causes of CH is indeed crucial for advancing research and developing effective treatment strategies. In this review, we will summarize the findings from existing studies on the causes of CH and propose potential research directions to further our understanding of this condition.

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Section: Introductionmentioning

confidence: 99%

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

Zhang,

Hu,

Wang

2024

Neurochem Res

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“…However, studies on the epidemiology of CNS malformations are relatively lacking. Some studies included relatively few cases, investigated only a few speci c CNS malformations in detail, did not include cases that were less than 28 weeks of gestational age, or investigated only a few epidemiological characteristics [23][24][25][26]. In-depth, comprehensive studies need to be included in China.…”

Section: Introductionmentioning

confidence: 99%

Congenital central nervous system malformations in Hunan Province, China, 2016-2020

Zhou

Xie

Peng

et al. 2023

Preprint

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Background This study aimed to analyze the epidemiological characteristics of congenital central nervous system (CNS) malformations, provide some information for intervention programs to reduce the incidence of CNS malformations. Methods Data were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. Incidences of CNS malformations (number of cases per 1000 fetuses (births and deaths at 28 weeks of gestation and beyond)) with 95% confidence intervals (CI) were calculated by year, gender, residence, and maternal age. Crude odds ratios (ORs) were calculated to examine the association of each maternal characteristic with CNS malformations. Results A total of 847755 fetuses (births and deaths)were registered, and 23420 birth defects were identified, including 1484 CNS malformations (which accounted for 6.34% of all birth defects). The incidence of CNS malformations was 1.75‰ (95%CI: 1.66,1.84). The incidence of CNS malformations at 28 weeks of gestation and beyond was 0.35‰ (95%CI: 0.31,0.39) (297 cases). The most frequent CNS malformations were hydrocephalus (462 cases, 31.13%), anencephaly (243 cases, 16.37%), spina bifida (220 cases, 14.82%), encephalocele (184 cases, 12.4%), holoprosencephaly (132 cases, 8.89%), cerebellar malformation (91 cases, 6.13%), corpus callosum agenesis (85 cases, 5.73%). CNS malformations were more common in males than females (1.53‰ vs. 1.28‰, OR=1.20, 95%CI: 1.07-1.34). Anencephaly (0.19‰ vs. 0.12‰, OR=1.59, 95%CI: 1.11-2.28) and corpus callosum agenesis (0.12‰ vs. 0.07‰, OR=1.69, 95%CI: 1.07-2.67) were more common in males than females, too. Holoprosencephaly was more common in urban than rural areas (0.19‰ vs. 0.13‰, OR=1.43, 95%CI: 1.02-2.02). Compared to mothers 25-29 years old, mothers <20 years old (OR=1.80, 95%CI: 1.31-2.46), 20-24 years old (OR=1.18, 95%CI: 1.01-1.37), and ≥35 years old (OR=1.17, 95%CI: 1.01-1.37) were risk factors for CNS malformations; And mothers <20 years old was a risk factor for anencephaly (OR=2.51, 95%CI: 1.31-4.80) and encephalocele (OR=2.73, 95%CI: 1.37-5.43); Mothers 20-24 years old (OR=1.41, 95%CI: 1.09-1.82) or ≥35 years old (OR=1.39, 95%CI: 1.07-1.81) were risk factors for hydrocephalus. The pregnancy outcomes of most CNS malformations were deaths (1421 cases, 95.75%), and most CNS malformations-related deaths were therapeutic terminations (98.45%, 1399/1421). Conclusion In summary, we have described the epidemiological characteristics of CNS malformations. Several mechanisms have been proposed to explain these phenomena. Our study is of great significance for CNS malformation intervention programs to reduce the incidence of CNS malformations.

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Pediatric Hydrocephalus in Brazil Public Health System: the Reality of a Developing Country in the Past 13 Years

Filho,

Mansouri,

Sarigul

et al. 2023

Preprint

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PURPOSE Pediatric hydrocephalus is a significant challenge in neurosurgery, particularly in resource-limited settings. This study focuses on the landscape of pediatric hydrocephalus neurosurgery in Brazil, a developing country, over the past 13 years. METHODS Data were collected from the Brazilian Hospital Information System, Live Birth Information System, and Mortality Information System records in the DATASUS (Departamento de Informática do SUS) database among January 2008 and the July 2021. Various health indicators were analyzed, including hospitalizations, treatment options, costs, and mortality rates. RESULTS During the period of study, Brazil recorded 8,493 new diagnoses of congenital hydrocephalus in live births, with 1,123 cases associated with spina bifida. The prevalence of congenital hydrocephalus was 241 cases per 100,000 live births, and 210 cases per 100,000 live births were attributed to congenital hydrocephalus not related to spina bifida. A total of 730 perinatal mortality cases related to congenital hydrocephalus were reported, with no clear trend over the 12-year period. The average number of perinatal mortality cases was 60.83 ± 13.98 per year. There were 1,063 infant mortality cases associated with hydrocephalus and 3,122 cases associated with congenital hydrocephalus, with no clear trend observed. The highest mortality rates for both diagnoses occurred between 3 to 5 months of age. Ethnicity and age were found to have significant relationships with mortality rates. A total of 217,900 hydrocephalus-related procedures were performed, with an increase in mean hospitalization cost and procedure numbers over the 13-year period. Mean cost per procedure had a significant negative effect on mean length of stay, while average professionals' salary did not have a significant effect. CONCLUSION Pediatric hydrocephalus in Brazil's public health system is a significant burden. Congenital hydrocephalus prevalence and mortality rates emphasize the need for better diagnosis and treatment. Early diagnosis, prenatal care, and adequate resources are crucial. This study offers insights into pediatric hydrocephalus in a developing country, highlighting challenges and future directions for improved care.

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Epidemiology of hydrocephalus in Brazil

Cited by 4 publications

References 24 publications

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

A Review of Cerebrospinal Fluid Circulation and the Pathogenesis of Congenital Hydrocephalus

Congenital central nervous system malformations in Hunan Province, China, 2016-2020

Pediatric Hydrocephalus in Brazil Public Health System: the Reality of a Developing Country in the Past 13 Years

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