{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:51:08Z","timestamp":1773269468609,"version":"3.50.1"},"reference-count":130,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Improving outcomes for pediatric patients with hydrocephalus in low- and middle-income countries (LMICs) requires research on ventriculoperitoneal shunt (VPS) complications and outcomes that may be comparable to studies conducted in high-income countries (HICs). The authors aimed to address this gap by conducting a systematic review to analyze VPS complications and outcomes among pediatric patients in LMICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This review adhered to PRISMA guidelines and the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) quality assessment. The authors screened English-language publications on pediatric VPS surgeries in LMICs, excluding studies from HICs and adult populations (&gt; 18 years), using 6 databases: PubMed\/Medline, Embase, Cochrane Library, Web of Science, Global Index Medicus, and Google Scholar. The search was completed on August 31, 2023. Data extraction included patient demographics, diagnosis, management, complications, and outcomes. Descriptive analyses were performed using Google Spreadsheets and R.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 590 studies were included, revealing trends in VPS utilization across 6 continents. Among 25,950 patients, the majority were aged 0\u20135 years (13,044\/15,008, 86.9%), with a slight male predominance (11,043\/19,971, 55.3%). Key complications included infections (mainly involving\n                      <jats:italic>Staphylococcus<\/jats:italic>\n                      spp.), shunt failure, and obstruction. Outcomes were reported for 7185 patients, representing 27.7% of the total cohort. Favorable outcomes were observed in 68.1% (4893 patients) and unfavorable outcomes in 13.1% (938 patients), and the overall mortality rate was 18.8% (1354 patients).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This review provides a comprehensive profile of VPS complications and outcomes in pediatric patients in LMICs. Despite a predominance of observational studies, these findings offer critical insights that may inform health policy and practice in LMICs. Future research should prioritize longitudinal studies to explore long-term outcomes, develop cost-effective approaches to reduce complications, and foster international collaborations to strengthen global neurosurgical capacity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.4.peds24598","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T13:18:01Z","timestamp":1755263881000},"page":"570-581","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of ventriculoperitoneal shunt surgery for hydrocephalus in children in low- and middle-income countries: a systematic review"],"prefix":"10.3171","volume":"36","author":[{"given":"Benjamin","family":"Mukumbya","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Duke University Health System;"},{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amos O.","family":"Adeleye","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurological Surgery, College of Medicine, University of Ibadan;"},{"name":"Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afnan Hassab E.","family":"Siddig","sequence":"additional","affiliation":[{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Duke University Global Health Institute, Durham, North Carolina;"},{"name":"Faculty of Medicine, University of Gezira, Wad Medani, Sudan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert H.","family":"Mbilinyi","sequence":"additional","affiliation":[{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Texas A&M College of Medicine, Bryan, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Woo","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chibueze","family":"Agwu","sequence":"additional","affiliation":[{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Pritzker School of Medicine, The University of Chicago Medical Center, Chicago, Illinois;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai Yan","family":"Min Htike","sequence":"additional","affiliation":[{"name":"Duke Kunshan University, Kunshan, China;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mubarak Jolayemi","family":"Mustapha","sequence":"additional","affiliation":[{"name":"Faculty of Basic Medical Sciences, University of Ilorin, Nigeria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaoluwa Ezekiel","family":"Dada","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Ibadan, Nigeria;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Ramos","sequence":"additional","affiliation":[{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Ross University School of Medicine, Miramar, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Adereti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lahey Hospital & Medical Center, Burlington, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph Mary","family":"Ssembatya","sequence":"additional","affiliation":[{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Division of Neurosurgery, Department of Surgery, Mbarara Regional Referral Hospital, Mbarara, Uganda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoey","family":"Petitt","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan E. H.","family":"Still","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Florida, Gainesville, Florida; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth R.","family":"Blackwood","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Library & Archives, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"von Isenburg","sequence":"additional","affiliation":[{"name":"Duke University Medical Center Library & Archives, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael M.","family":"Haglund","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Health System;"},{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Duke University Global Health Institute, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alvan-Emeka K.","family":"Ukachukwu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Duke University Health System;"},{"name":"Duke Global Neurosurgery and Neurology, Durham, North Carolina;"},{"name":"Duke University Global Health Institute, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"CNS Neurosci Ther","first-page":"804","article-title":"Effectiveness and safety of ventriculoperitoneal shunt versus lumboperitoneal shunt for communicating hydrocephalus: a systematic review and meta-analysis with trial sequential analysis","volume":"29","author":"Ho Y","year":"2023","unstructured":"Ho Y, Chiang W, Huang H, Lin S, Tsai S. Effectiveness and safety of ventriculoperitoneal shunt versus lumboperitoneal shunt for communicating hydrocephalus: a systematic review and meta-analysis with trial sequential analysis. CNS Neurosci Ther. 2023;29(3):804\u2013815."},{"issue":"1","key":"b2","series-title":"J Neurosurg Pediatr","first-page":"109","article-title":"The cost of hydrocephalus: a cost-effectiveness model for evaluating surgical techniques","volume":"23","author":"Lim J","year":"2019","unstructured":"Lim J, Tang AR, Liles C,  The cost of hydrocephalus: a cost-effectiveness model for evaluating surgical techniques. 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