{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:32:00Z","timestamp":1791444720632,"version":"4.3.3"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Postinfectious hydrocephalus (PIH) in infants is a major public health burden in sub-Saharan Africa. In a previously reported randomized trial, the authors found no significant differences in outcome between endoscopic versus shunt treatment, with stagnation in brain growth at 2 years after treatment. They now present the 5-year follow-up results of this cohort, assessing detailed developmental, quality of life, and brain volume outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors performed a trial at a single center in Mbale, Uganda, involving 100 infants (&lt; 180 days of age) with PIH randomized to endoscopic third ventriculostomy plus choroid plexus cauterization (ETV\/CPC) or ventriculoperitoneal shunt (VPS) treatment. After 5 years, they assessed developmental outcomes with the Vineland Adaptive Behavior Scales, Third Edition (VABS-3), quality of life with the Health Utilities Index Mark 3 (HUI-3) and Hydrocephalus Outcome Questionnaire (HOQ), and brain volume derived from CT scans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Sixty-three infants were assessed for 5-year outcomes (35 ETV\/CPC and 28 VPS, by intention to treat). There were no significant differences between the two surgical treatment arms in treatment failure (p = 0.39), VABS-3 scores (p &gt; 0.52), HUI-3 utility scores (p &gt; 0.37), HOQ scores (p &gt; 0.18), or brain volume (raw p = 1.0, adjusted p = 0.24). There were strong correlations between VABS-3, HUI-3, and HOQ scores with brain volume adjusted for age and sex, and weaker correlations when adjusted for anthropometric measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>These results suggest that ETV\/CPC and VPS treatment have comparable long-term outcomes for infants in medically resource-constrained environments. Furthermore, brain volume strongly correlates with developmental and quality of life metrics, emphasizing the need to focus on optimizing brain volume growth potential in infants with severe perinatal neurological insults such as infection and hydrocephalus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.1.peds24417","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T22:44:15Z","timestamp":1746225855000},"page":"135-144","source":"Crossref","is-referenced-by-count":5,"title":["Five-year outcomes after surgical treatment of infant postinfectious hydrocephalus in sub-Saharan Africa: results of a randomized trial"],"prefix":"10.3171","volume":"36","author":[{"given":"Edith","family":"Mbabazi-Kabachelor","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"},{"name":"Department of Neurosurgery, Yale University, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mallory R.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Mugamba","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ssenyonga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"},{"name":"Department of Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Onen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"},{"name":"Department of Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Nalule","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Magombe","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CURE Children\u2019s Hospital of Uganda, Mbale, Uganda;"},{"name":"Department of Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkateswararao","family":"Cherukuri","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Pennsylvania State University, State College, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Monga","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering, Pennsylvania State University, State College, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J.","family":"Schiff","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Yale University, New Haven, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhaya V.","family":"Kulkarni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Hospital for Sick Children, Toronto, Ontario, Canada;"},{"name":"Department of Neurosurgery, University of Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin C.","family":"Warf","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts; and"},{"name":"Department of Neurosurgery, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","first-page":"1065","article-title":"Global hydrocephalus epidemiology and incidence: systematic review and meta-analysis","volume":"130","author":"Dewan MC","year":"2018","unstructured":"Dewan MC, Rattani A, Mekary R,  Global hydrocephalus epidemiology and incidence: systematic review and meta-analysis. 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J Neurosurg Pediatr. 2021;28(3):326\u2013334."},{"issue":"1 suppl","key":"b4","series-title":"J Neurosurg","first-page":"1","article-title":"Hydrocephalus in Uganda: the predominance of infectious origin and primary management with endoscopic third ventriculostomy","volume":"102","author":"Warf BC","year":"2005","unstructured":"Warf BC. Hydrocephalus in Uganda: the predominance of infectious origin and primary management with endoscopic third ventriculostomy. J Neurosurg. 2005;102(1 suppl):1\u201315."},{"issue":"6 suppl","key":"b5","series-title":"J Neurosurg","first-page":"475","article-title":"Comparison of endoscopic third ventriculostomy alone and combined with choroid plexus cauterization in infants younger than 1 year of age: a prospective study in 550 African children","volume":"103","author":"Warf BC","year":"2005","unstructured":"Warf BC. 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