Timing of ventriculoperitoneal shunt insertion following spina bifida closure in Kenya

Margaron, Franklin C.; Poenaru, Dan; Bransford, Richard J.; Albright, A. Leland

doi:10.1007/s00381-010-1156-4

Cited by 19 publications

(14 citation statements)

References 26 publications

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“…However, amidst such evidence, it is important to note that the results of the current study present contrasting views of male predominance in the management. With such distinct evidence, it is essential to highlight that some sub-Saharan African countries like Nigeria and Cameroon have presented results showing male predominance during the management, [15,17] hence the results are in line with such findings. Probably an explanation can be connected to ethno-theories where boys are much more treasured than girls in most societies in sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 59%

Ethnic Pattern of Origin of Children with Spina Bifida Managed at the University Teaching Hospital and Beit Cure Hospital, Lusaka, Zambia 2001-2010

Mweshi¹

2015

SJPH

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The incidence of spina bifida (SB) is known to differ among regions. Very little has been reported about the relationship between the incidence of SB and ethnic patterns of origin in Zambia except for the general impression that it is prevalent. The aim of the study was to establish the ethnic pattern of origin of children with SB in Zambia. It was a retrospective cross sectional study. Using a checklist, data was collected from clinical files of children with SB from the University Teaching Hospital (UTH) and Beit Cure Hospital (BCH) from 2001-2010. Descriptive statistical analysis was done in SPSS version 17. A total of 253 children with SB were identified of whom 88 (35%) of them originally came from the Southern Province of the country while the lowest province was the NorthWestern Province with 7 (3%). Further, a total of 77 (30%) children were referred from the Southern Province of the country and the lowest province that was represented was the NorthWestern Province with 5 (2%). Observed is the evidence that SB is very prevalent in the Southern Province of the country. With the presence of Uranium in the Southern Province of Zambia, a serious study ought to be done to investigate the possible link of the pollutant with the prevalence of SB in the region. It is essential that the government looks seriously at Uranium Mines being operated in the Province.

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Section: Discussionmentioning

confidence: 59%

Ethnic Pattern of Origin of Children with Spina Bifida Managed at the University Teaching Hospital and Beit Cure Hospital, Lusaka, Zambia 2001-2010

Mweshi¹

2015

SJPH

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“…In studies comparing shunt infection rates for children undergoing MMC repair and shunting for hydrocephalus, placement of a shunt at the time of repair has been associated with a dramatically higher rate of infection when compared to placement 5-10 days later in populations with a high risk of substerile birthing conditions [25]. A study by Pople et al [26] suggested that delay beyond 6 months of life for shunting was associated with a lower shunt infection rate than shunting in infants younger than 6 months (5.6 vs. 15.7%) in a modern Western hospital setting.…”

Section: Discussionmentioning

confidence: 99%

The Use of External Ventricular Drainage to Reduce the Frequency of Wound Complications in Myelomeningocele Closure

et al. 2018

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Introduction: Myelomeningocele (MMC) is an open neural tube defect routinely surgically closed within 48 h of birth to prevent secondary infection. Up to 18% of patients experience wound complications, and 85% require shunting for hydrocephalus. We hypothesized that wound complications could be reduced by cerebrospinal fluid (CSF) diversion at the time of closure. Methods: Institutional review board approval was obtained to review records of the 88 patients who underwent MMC closure between January 2005 and June 2016 at the Children's Hospital of Pittsburgh. Twenty-three patients (26%) had an external ventricular drain (EVD) placed at the time of MMC closure and underwent 7-11 days of CSF drainage. Fourteen patients (16%) had a shunt placed at the time of MMC closure, and 51 (58%) had no form of CSF diversion at the time of MMC closure. Results: Patients with an EVD or shunt placed at the time of closure had no wound complications. In contrast, 8 patients (16%) without CSF diversion at closure developed wound complications (p = 0.048). Seven of the 8 wound complications occurred in the 71 patients with evidence of hydrocephalus at birth (p = 0.98). Of patients with evidence of hydrocephalus at the time of MMC closure, wound complications had a higher rate of occurrence among patients who did not receive a shunt or EVD at closure (p = 0.01). When comparing only patients with evidence of hydrocephalus at birth, the EVD group alone had a lower rate of wound complications than patients who did not receive CSF diversion at the time of closure (p = 0.031). Conclusions: These results suggest that addressing hydrocephalus at the time of MMC closure significantly reduces the likelihood of wound complications and may justify temporary CSF diversion at birth, at least in those patients manifesting hydrocephalus.

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“…Nongenetic structural defects can occur for several reasons. Hydrocephalus is strongly associated with myelomeningocele, and this defect is caused by a deficiency of folic acid in the maternal diet (15,21). Multivitamin supplements during pregnancy have been shown to reduce the risk of hydrocephalus (11,15).…”

Section: Discussionmentioning

confidence: 99%

“…Hydrocephalus is strongly associated with myelomeningocele, and this defect is caused by a deficiency of folic acid in the maternal diet (15,21). Multivitamin supplements during pregnancy have been shown to reduce the risk of hydrocephalus (11,15). Low maternal age has been associated with a higher risk of hydrocephalus, probably because younger mothers are less likely to receive prenatal screening (25).…”

Section: Discussionmentioning

confidence: 99%

Challenges in the Management of Hydrocephalic Children in Northern Mozambique

et al. 2015

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Timing of ventriculoperitoneal shunt insertion following spina bifida closure in Kenya

Abstract: This study indicates that in developing countries, patients with SB who present in a delayed fashion but require shunting and have sterile CSF, should have their shunts inserted 5-10 days after SB closure.

Cited by 19 publications

References 26 publications

Ethnic Pattern of Origin of Children with Spina Bifida Managed at the University Teaching Hospital and Beit Cure Hospital, Lusaka, Zambia 2001-2010

Ethnic Pattern of Origin of Children with Spina Bifida Managed at the University Teaching Hospital and Beit Cure Hospital, Lusaka, Zambia 2001-2010

The Use of External Ventricular Drainage to Reduce the Frequency of Wound Complications in Myelomeningocele Closure

Challenges in the Management of Hydrocephalic Children in Northern Mozambique

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