1315. Management of child Hydrocephalus in the Chad

Authors: Yannick Canton Kessely, MD; Felicien Toudjingar, MD; Florent HIBE, MD; Succès Dobian, MD; Olivier Ngariguem, MD; Mahamat nour, MD; Momar Codé Ba, MD (N'djamena, Chad)

Introduction: The care of child hydrocephalus in Chad remains acultural and scientific challenge. With the recent advent of the neurosurgeryin this country, several dificulties are to be overcome Methods: It's about prospective studyconcerning 43 children having benefited from a ventriculoperitoneal shunt for hydrocephalus during the nine first months of the year 2018. Results: The patients were 31 month-old on average with extreme from 3 months to 12 years. The boys represented 65% of the patients. No mother has benefited during the pregnancy for acid folic supplementation. The prenatal ultrasound was realized in 8 cases (31%) and the prenatal diagnosis was made in 3 cases. the family consanguinity was found in 23% of cas and 37% of the mothed developped a feverish affection not documented during the pregnancy wich they qulified as 'Malaria'. The average cranial perimeter id 54,5 centimeter with the extremes from 47 to 81 centimeter; All the patient have done brain CT-scan. There were seven cas of obstructive hydrophalus by tumor of the posterieor fossa, one case by craniopharyngioma. 9 children presented with scarification as aftereffects of traditional treament. Th hydrocephalus was associated with cephalocele in 4 cases and with myelomeningocele in 3 cases. Ther was a death arisen in intensive care unit and 6 cases of death post-meningitidis. The avarege cost of coverageof the hydrocephalus is 944,9 dollars widely above theaverage wage. Conclusion: The care of hydrocephalis in Chad remains expensive. The weight of the faith and the traditional treatment delay the coverage.