5 research outputs found
Complications of ventriculoperitoneal shunts in children in Dar es Salaam
Background: From the few reports available, VP shunt surgery in sub-
Saharan Africa is associated with significant complications. This study
was aimed at establishing the pattern, causes and frequency of
complications of VPS in Tanzania. Methods: Sixty five of the 102
children with hydrocephalus treated with ventriculoperitoneal shunts
between January 1996 and January 1999 were studied prospectively. The
first follow-up was at 2 weeks postoperative when the wounds were
evaluated and occipitofrontal circumference measured. Further
follow-ups were at 4 weeks and at three months. Collaborating staff of
the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT)
thereafter regularly followed up the children at home. Results: The
male to female ratio was 1.8 to 1. Forty-seven of the children (72%)
were less than 12 months old but no patient was under 1 month of age at
operation. The mean occipitofrontal circumference was 50.7cm. Shunt
blockage was the commonest complication (32.3%) followed by infection
(24.6%). The combined complication rate of shunt infection and wound
infection was 46.1%. Shunt-related mortality was 13 (20.0%). There was
no statistically significant correlation between the occipitofrontal
circumference and type of complication or mortality. The mean age among
the patients showing disconnection was 21.3 months compared to a mean
age of 8.1 months for those not having this complication (P-value=0.04)
Conclusion: The complication rates were higher than those in Western
series but compared well with findings from sub Saharan Africa other
studies