Correction: Age-specific global epidemiology of hydrocephalus: Systematic review, metanalysis and global birth surveillance

The Ventriculoperitoneal Shunt Complication Rate in Baghdad Medical City from 2019 to 2022

OBJECTIVE

Due to the substantial lack of data from Iraq on ventriculoperitoneal shunt (VPS) complications, this study aims to examine the various types of complications after VPS surgery in Baghdad Medical City.

METHODS

The retrospective cohort study analyzed VPS procedures at Baghdad Medical City from 2019 to 2022. The overall complication rate, including infection and shunt malfunction, was determined from patient records. Data were analyzed using descriptive statistics and Kaplan-Meier survival analysis. Ethical approval was obtained from the institutional review board, with consent waived due to the study's retrospective nature. The findings highlight the need for improved management to reduce complication rates in VP shunt procedures.

RESULTS

The study involved 113 participants with an average age of 2.62 years (±3.4). The most common indications for VPS placement are congenital hydrocephalus (40%) and postinfectious hydrocephalus (30%). The most common complications of post-VPS surgery are VP obstruction (54%) and postsurgical infections (44%). There were no significant differences in the incidence of postoperative complications across different age groups.

CONCLUSIONS

Our study showed the significant complication rate associated with VPS surgeries for hydrocephalus, particularly VPS infections and obstruction. There were no significant age-related differences in VPS complication rates across age groups.

Epidemiology of hydrocephalus in Brazil

OBJECTIVE

Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS).

METHODS

This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs.

RESULTS

In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars.

CONCLUSIONS

Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.

Genes causing congenital hydrocephalus: Their chromosomal characteristics of telomere proximity and DNA compositions

Congenital hydrocephalus (CH) is caused by genetic mutations, but whether factors impacting human genetic mutations are disease-specific remains elusive. Given two factors associated with high mutation rates, we reviewed how many disease-susceptible genes match with (i) proximity to telomeres or (ii) high adenine and thymine (A + T) content in human CH as compared to other disorders of the central nervous system (CNS). We extracted genomic information using a genome data viewer. Importantly, 98 of 108 genes causing CH satisfied (i) or (ii), resulting in >90% matching rate. However, such a high accordance no longer sustained as we checked two factors in Alzheimer's disease (AD) and/or familial Parkinson's disease (fPD), resulting in 84% and 59% matching, respectively. A disease-specific matching of telomere proximity or high A + T content predicts causative genes of CH much better than neurodegenerative diseases and other CNS conditions, likely due to sufficient number of known causative genes (n = 108) and precise determination and classification of the genotype and phenotype. Our analysis suggests a need for identifying genetic basis of both factors before human clinical studies, to prioritize putative genes found in preclinical models into the likely (meeting at least one) and more likely candidate (meeting both), which predisposes human genes to mutations.