TITLE:
Outcome of Children under Five Years Old Operated on for Hydrocephalus in University Hospital Centers in Togo
AUTHORS:
Abd El Kader Moumouni, Maman Sani Rabiou, Essosalam Essotina, Dabou Abiba Tamou Tabe, Doleagbenou Komlan Agbeko, Solim Mariam Tablousma, Opekou Donkor Fabie, Hodabalo Essosolim Bakonde, Winie Tchedre, Oniwa Solange Katagna, Ramdane Issifou, Katanga Anthony Beketi, Essosinam Kpélao
KEYWORDS:
Hydrocephalus, Child, Ventriculoperitoneal Shunt, Prognosis, Togo
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.16 No.2,
April
1,
2026
ABSTRACT: Introduction: Infant hydrocephalus remains a major public health problem in sub-Saharan Africa, where the prognosis is still marked by high mortality and significant sequelae, despite advances in neurosurgery. In Togo, data on the medium- and long-term outcomes of operated children are still scarce. The objective of this study was to assess the vital, neurodevelopmental, and social outcomes of children under five years old who underwent surgery for hydrocephalus in Togo. Study Setting and Methodology: This was a descriptive and analytical, retrospective study with prospective data collection, conducted from January 1, 2011, to December 31, 2021, in the university hospital centers (CHU) of Togo. All children aged ≤ 5 years who underwent surgery for hydrocephalus exclusively by ventriculoperitoneal shunt (VPS) were included. Sociodemographic, clinical, diagnostic, therapeutic, and outcome data were analyzed. Results: Seventy-one children were included. The mean age was 8 ± 0.95 months, with a male predominance (56.34%). Congenital malformations were the main etiology (47.89%). All patients had undergone ventriculoperitoneal shunting (VPS). Immediate postoperative mortality was zero (0%), but with a follow-up of 5 to 15 years, it reached 43.66%. Among the survivors, 52.11% showed improvement in psychomotor development, 32.39% had stable development, and 15.49% experienced regression. Surgery performed at ≤ 5 months of age was significantly associated with better survival (OR = 3.10; p = 0.022) and fewer sequelae. A management delay of ≤ 14 days was significantly associated with better survival (OR = 3.29; p = 0.0375). Conclusion: Operated infantile hydrocephalus in Togo remains associated with high mortality and major sequelae, mainly due to delayed diagnosis and insufficient postoperative follow-up. Enhanced early screening, multidisciplinary follow-up, and better access to specialized care would improve the prognosis.