When spina bifida-associated hydrocephalus was included, the prevalence increased to 87.8/100,000 ( Fig 2). The pooled prevalence of isolated hydrocephalus in the pediatric population was 71.9/100,000. The overall global prevalence of hydrocephalus was 84.7/100,000. The median study quality score was 5/8 (range 3–8). Of the 52 studies reporting on the prevalence of hydrocephalus, 40 (77%) were in the pediatric population, 7 (13%) in the elderly population and 5 (10%) in adult population. Prevalence of hydrocephalus (systematic review) Prevalence was reported as rates per 100,000. All statistical analyses were carried out in R version 2.14. To that effect, in addition to analyzing hydrocephalus-only cases, separate analyses were performed where 80% of spina bifida cases was added to the hydrocephalus cases prior to performing pooled analyses. The prevalence of hydrocephalus in spina bifida, which has been quoted as approximately 80% in the literature, was used to adjust the estimates of hydrocephalus in the pediatric population. Confidence intervals were calculated using the Clopper-Pearson or “exact” binomial method. Given disparate study methods and populations sampled, a random effects model was used to obtain a pooled prevalence per 100,000 people with a 95% confidence interval. To assess for significant between-study heterogeneity the Cochrane Q statistic was calculated and I 2 was used to quantify between-study heterogeneity. The prevalence models were further stratified by country, continent and paper quality score. The prevalence of hydrocephalus was analyzed for specific age groups: pediatric (perinatal to age 18), adults (age 19 to 64), and elderly (age 65 and above) and by continent. Synthesis of results (prevalence analysis). The aim of our study was two-fold: 1) to utilize the International Clearinghouse Centre for Birth Defects Surveillance and Research (ICBDSR) registry to determine the incidence of childhood hydrocephalus and understand the effect of country-specific income level and mandatory folate fortification on the reported incidence rates and 2) to determine the age- and region-specific global prevalence of hydrocephalus using a systematic review and metanalysis of published reports. recently presented a systematic review and metanalysis of the region-specific global incidence of childhood hydrocephalus. Better epidemiologic information will facilitate recommendations for appropriate research and patient-care resource mobilization. Defining the global epidemiology of hydrocephalus is a logical first step to understand its burden. With a four-fold variation in reported rates, accurate resource allocation and planning is challenging, which negatively impacts efforts to improve patient outcomes. Despite the substantial demands it places on patients and healthcare providers, hydrocephalus is under-recognized, and incentives to attract specialized health care providers and researchers in the field are limited. Nevertheless, there is heterogeneity in the reported prevalence and incidence of hydrocephalus, often without reference to age or etiology. Hydrocephalus can present at any age and is a major cause of mortality and morbidity worldwide. While untreated hydrocephalus may result in progressive neurologic injury and death, complete resolution of symptoms can be achieved with early diagnosis and surgical intervention. Hydrocephalus encompasses a heterogeneous group of pathologies, characterized by abnormal dilatation of the cerebral ventricles. However, the funder had no role in study design, data collection, data analysis, data interpretation, writing of the report, or decision to submit the findings for publication.Ĭompeting interests: The authors have declared that no competing interests exist. Mark Hamilton, Tamara Pringsheim and Nathalie Jette. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This study has been sponsored by the Public Health Agency of Canada. Received: JAccepted: SeptemPublished: October 1, 2018Ĭopyright: © 2018 Isaacs et al. PLoS ONE 13(10):Įditor: Wisit Cheungpasitporn, University of Mississippi Medical Center, UNITED STATES (2018) Age-specific global epidemiology of hydrocephalus: Systematic review, metanalysis and global birth surveillance. Citation: Isaacs AM, Riva-Cambrin J, Yavin D, Hockley A, Pringsheim TM, Jette N, et al.
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