National Planning Authority

Sep 08, 2019

It is estimated that between 3,600 to 5,400 new cases of hydrocephalus occur each year in Uganda, according to Dr Ssenyonga, the Medical director of CURE Hospital

Dr Ivan Lule (centre in suit), an NPA board member, with the CURE and NPA team recently at CURE Hospital in Mbale

A new and efficient way of treating hydrocephalus and spina bifida has been developed at Cure Children's Hospital in Mbale. Hydrocephalus, commonly referred to as "water in the brain", is caused by blockage of the brain's ventricles, leading to a disruption in the outflow of cerebrospinal fluid (CSF). The condition leaves patients with an abnormally big head. Peter Ssenyonga, the Medical Director at CURE Hospital says that the condition is caused by the accumulation of cerebrospinal fluid.

It mostly affects newly born babies, but it is also been registered on rare occasions amongst adults as well. It presents with high fever, convulsions, lack of appetite, irritation and a bulging head. According to Ssenyonga, if untreated, hydrocephalus can lead to significant physical and developmental problems or even lead to death. Traditionally, children suffering from hydrocephalus are treated using a shunt system to drain the accumulated fluid from the brain.

This involves inserting a permanent tube(shunt)into the fluid spaces of the head of the patient that helps to drain the fluid into the abdomen. New procedure CURE Children's Hospital has developed a new procedure which according to Ssenyonga is more effective. He explains that the new procedure, which was developed by Dr Benjamin Warf, the hospital's founding Medical Director, requires the use of an endoscopic technique through the nose.

It results in faster recovery, a shorter admission period, less risk and fewer problems compared to the shunt system. This procedure combines endoscopic third ventriculostomy (ETV) with a choroid plexus cauterisation (CPC), to provide a safer, more sustainable solution than the use of a shunt. Ssenyonga says it would cost about sh20m to treat the condition in Western countries.

However, at CURE, the treatment and surgery of hydrocephalus and spina bifida is sh5.5m, but the patients pay a subsidized fee of sh950,000, which can be paid in instalments. It is estimated that between 3,600 to 5,400 new cases of hydrocephalus occur each year in Uganda, according to Ssenyonga. He says lack of specialised training and awareness about the condition has left most health workers ignorant hence contributing to the delayed referral and late presentation of patients for treatment. Ssenyonga adds that in some communities, the condition is considered to be a curse, and some parents are forced to abandon their children in fear of the consequences. To avoid this condition, he says expectant mothers are advised to deliver in health units with good hygienic conditions.

In Uganda, children who suffer from ailments such as hydrocephalus have little hope for a productive future. If they do not die, they are stigmatised for the rest of their lives. Their families also often encounter similar rejection from communities where they live.

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