Neurosurgery practice · 2025
Myelomeningocele in the Pediatric Neurosurgery Department at Bernard Mevs Hospital in Haiti: A Retrospective Analysis.
СтатьяНазвание и аннотация: Перевод в очереди
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Alphonse Berley, Darko Kwadwo, Michelande Elien, Limann Bernice, Ovil Ricarven, Ulysse James, Barrie Umaru, Detchou Donald, Lafortune Yudy, Valsaint Jérôme Patrick
Аннотация
BACKGROUND AND OBJECTIVE: Birth defects occur more often in low-income and middle-income countries. This study delineates the epidemiology of myelomeningocele (MMC) patients presenting to the Bernard Mevs Hospital (HBM) in Haiti.
METHODS: Pediatric patients with MMC at HBM between 2018 and 2022 were reviewed, and statistical analyses were performed.
RESULTS: The study included 54 spina bifida patients with a mean age of 1.2 ± 2.4 months, predominantly male (64.8%, n = 35). The prevalence from 2018 to 2022 was approximately 0.4 cases per 10 000 live births. Half of the patients (50.0%, n = 27) had a birth weight of 2500 to 4000 g. Hydrocephalus was commonly associated, present in 55.6% (n = 30) of patients. Lumbar defects were most frequent, found in 63% (n = 34) of cases. The average hospital stay was 31.3 ± 43.5 days, with 94.4% (n = 51) showing clinical improvement; there were 3 deaths (5.6%). Regarding timing of intervention, 25.9% (14/54) underwent early repair and 74.1% (40/54) late repair. Hydrocephalus was present in 64.3% of the early group and 52.5% of the late group (P = .652). Favorable postoperative results were slightly lower in the early group (85.7% vs 97.5%, P = .328). Folate supplementation was reported in 44.4% (n = 24) of mothers, and unemployment was common among parents, with 42.6% of mothers and 31.5% of fathers being unemployed.
CONCLUSION: The study highlights the epidemiology of MMC at HBM, with a high prevalence of hydrocephalus and lumbar defects. Shorter postoperative stays were linked to better outcomes. The findings highlight the need for improved prenatal care, folate supplementation, and addressing socioeconomic challenges to improve outcomes.
METHODS: Pediatric patients with MMC at HBM between 2018 and 2022 were reviewed, and statistical analyses were performed.
RESULTS: The study included 54 spina bifida patients with a mean age of 1.2 ± 2.4 months, predominantly male (64.8%, n = 35). The prevalence from 2018 to 2022 was approximately 0.4 cases per 10 000 live births. Half of the patients (50.0%, n = 27) had a birth weight of 2500 to 4000 g. Hydrocephalus was commonly associated, present in 55.6% (n = 30) of patients. Lumbar defects were most frequent, found in 63% (n = 34) of cases. The average hospital stay was 31.3 ± 43.5 days, with 94.4% (n = 51) showing clinical improvement; there were 3 deaths (5.6%). Regarding timing of intervention, 25.9% (14/54) underwent early repair and 74.1% (40/54) late repair. Hydrocephalus was present in 64.3% of the early group and 52.5% of the late group (P = .652). Favorable postoperative results were slightly lower in the early group (85.7% vs 97.5%, P = .328). Folate supplementation was reported in 44.4% (n = 24) of mothers, and unemployment was common among parents, with 42.6% of mothers and 31.5% of fathers being unemployed.
CONCLUSION: The study highlights the epidemiology of MMC at HBM, with a high prevalence of hydrocephalus and lumbar defects. Shorter postoperative stays were linked to better outcomes. The findings highlight the need for improved prenatal care, folate supplementation, and addressing socioeconomic challenges to improve outcomes.