{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T17:07:44Z","timestamp":1792516064433,"version":"4.5.0"},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Clinical and economic repercussions of ventricular shunt infections are magnified in low-resource countries. The efficacy of antibiotic-impregnated shunts in this setting is unclear. A previous retrospective cohort study comparing the Bactiseal Universal Shunt (BUS) and the Chhabra shunt provided clinical equipoise; thus, the authors conducted this larger randomized controlled trial in Ugandan children requiring shunt placement for hydrocephalus to determine whether there was, in fact, any advantage of one shunt over the other.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between April 2013 and September 2016, the authors randomly assigned children younger than 16 years of age without evidence of ventriculitis to either BUS or Chhabra shunt implantation in this single-blind randomized controlled trial. The primary outcome was shunt infection, and secondary outcomes included reoperation and death. The minimum follow-up was 6 months. Time to outcome was assessed using the Kaplan-Meier method. The significance of differences was tested using Wilcoxon rank-sum, chi-square, Fisher\u2019s exact, and t-tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of the 248 patients randomized, the BUS was implanted in 124 and the Chhabra shunt in 124. There were no differences between the groups in terms of age, sex, or hydrocephalus etiology. Within 6 months of follow-up, there were 14 infections (5.6%): 6 BUS (4.8%) and 8 Chhabra (6.5%; p = 0.58). There were 14 deaths (5.6%; 5 BUS [4.0%] vs 9 Chhabra [7.3%], p = 0.27) and 30 reoperations (12.1%; 15 BUS vs 15 Chhabra, p = 1.00). There were no significant differences in the time to primary or secondary outcomes at 6 months\u2019 follow-up (p = 0.29 and 0.17, respectively, Wilcoxon rank-sum test).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Among Ugandan infants, BUS implantation did not result in a lower incidence of shunt infection or other complications. Any recommendation for a more costly standard of care in low-resource countries must have contextually relevant, evidence-based support.<\/jats:p><jats:p>Clinical trial registration no.: PACTR201804003240177 (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.pactr.org\/\">http:\/\/www.pactr.org\/<\/jats:ext-link>)<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.10.peds18354","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:51:48Z","timestamp":1551228708000},"page":"397-406","source":"Crossref","is-referenced-by-count":19,"title":["Infection risk for Bactiseal Universal Shunts versus Chhabra shunts in Ugandan infants: a randomized controlled trial"],"prefix":"10.3171","volume":"23","author":[{"given":"Edith","family":"Mbabazi-Kabachelor","sequence":"first","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghal","family":"Shah","sequence":"additional","affiliation":[{"name":"Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts;"},{"name":"Warren Alpert Medical School, Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerry A.","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts;"},{"name":"Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mugamba","sequence":"additional","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ssenyonga","sequence":"additional","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Onen","sequence":"additional","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Nalule","sequence":"additional","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kush","family":"Kapur","sequence":"additional","affiliation":[{"name":"Department of Neurology, Harvard Medical School, Harvard University; and"},{"name":"Clinical Research Center, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin C.","family":"Warf","sequence":"additional","affiliation":[{"name":"CURE Children\u2019s Hospital, Mbale, Uganda;"},{"name":"Global Neurosurgery Initiative, Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts;"},{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1007\/BF00271135","article-title":"Cerebrospinal fluid shunt infections in children. 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