Affiliations: [a] Department of Child Neurology and Developmental Neuroscience, Texas Children’s Hospital – Baylor College of Medicine, Houston, TX, USA | [b] Developmental and Behavioral Pediatrics, Department of Pediatrics, Texas Children’s Hospital – Baylor College of Medicine, Houston, TX, USA | [c] Liberty University, Lynchburg, VA, USA
Correspondence:
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Corresponding author: Jonathan Castillo, Developmental and Behavioral Pediatrics, Department of Pediatrics, Texas Children’s Hospital – Baylor College of Medicine, 8080 North Stadium Drive, Houston, TX 77054, USA. Tel.: +1 832 822 3400; E-mail: jcporter@texaschildrens.org.
Abstract: PURPOSE: Endoscopic Third Ventriculostomy (ETV) and Choroid Plexus Cautery (CPC) are low-cost, safe, and promising interventions for spina bifida-associated hydrocephalus (SBHCP). The purpose of this review was to explore and describe these efforts in Africa in order to upscale surgical training and rehabilitation services. METHODS: A PubMed search for articles on ETV and CPC as management of SBHCP in Africa was performed. Two authors appraised the results for key themes in content: indications, technique, outcomes, complications, education, and rehabilitation. RESULTS: Twenty of 47 articles identified were included for appraisal. Twelve described indications, ten and seven outlined technique and complications, respectively, and four described predictors of operative success. Fourteen studies describe outcomes, including operative and neurodevelopmental outcomes. Only two outlined educational efforts. Half of the literature stems from a single site in Uganda; in total, only six countries were represented. No articles described significant post-operative rehabilitation services or related training. CONCLUSION: The experience of ETV and CPC in Africa is promising, however, efforts to train and empower local staff in surgical technique and methods to upscale post-operative community-based rehabilitation services remain as a key to long-term success.
Keywords: Myelomeningocele, hydrocephalus, global health, neurosurgery, rehabilitation, Africa
