Observational studyChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2020
A perspective in the management of myelomeningocoele in the KwaZulu-Natal Province of South Africa.
Observational study in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 16 citations in OpenAlex.
- Meningomyelocele Perioperative Management in Neonatal: Case Series.Children (Basel, Switzerland) · 2024Article
- The Importance of Neurosurgical Intervention and Surgical Timing for Management of Pediatric Patients with Myelomeningoceles in Bangladesh.World neurosurgery · 2024Article
- Single surgeon case series of myelomeningocele repairs in a developing world setting: Challenges and lessons.World neurosurgery: X · 2023Article
- Article
- Seeking tirelessly for better health and life conditions for the child with myelomeningocele.Revista latino-americana de enfermagem · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundMyelomeningocoele (MMC) is common in the developing world. The purpose of this study was to investigate the clinical characteristics and management of myelomeningocoele and to identify factors contributing to outcomes.
methodsThis was a retrospective, observational study of consecutive children diagnosed with MMC managed in the Paediatric Neurosurgery Unit at Inkosi Albert Luthuli Central Hospital. Multiple logistic regression analysis identified clinical characteristics, demographics and surgical variables that were associated with outcome.
resultsA total of 309 children were managed during this period (M:F 1.3:1). The most common sites were lumbar, lumbo-sacral and sacral. Mean age at surgical repair was 4.7 ± 15.6 months. Two hundred and eight children had ventriculomegaly, of whom 158 had symptomatic hydrocephalus, requiring CSF diversion. Fifty-eight (21%) patients developed wound sepsis, of whom 13 (22%) developed meningitis (p = 0.001). The time to wound sepsis was 9.5 ± 3.6 days. The commonest organism isolated was Staphylococcus aureus followed by MRSA. Thirty-two patients (23%) developed shunt malfunction and three (11%) developed ETV malfunction. Twenty children (9%) demised during the admission period. Death was associated with meningitis (p < 0.0001), and meningitis itself was associated with wound sepsis (p < 0.0001). Hospital stay was 20.4 ± 16 days. Wound sepsis (p = 0.002) and meningitis (p < 0.0001), respectively, were associated with prolonged hospital stay.
conclusionThere was a slight male preponderance and hydrocephalus occurred in two thirds of cases. Wound sepsis and meningitis were associated poor outcomes.
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