PLoS ONE (Jan 2018)

Age-specific global epidemiology of hydrocephalus: Systematic review, metanalysis and global birth surveillance.

  • Albert M Isaacs,
  • Jay Riva-Cambrin,
  • Daniel Yavin,
  • Aaron Hockley,
  • Tamara M Pringsheim,
  • Nathalie Jette,
  • Brendan Cord Lethebe,
  • Mark Lowerison,
  • Jarred Dronyk,
  • Mark G Hamilton

DOI
https://doi.org/10.1371/journal.pone.0204926
Journal volume & issue
Vol. 13, no. 10
p. e0204926

Abstract

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BACKGROUND:Hydrocephalus is a debilitating disorder, affecting all age groups. Evaluation of its global epidemiology is required for healthcare planning and resource allocation. OBJECTIVES:To define age-specific global prevalence and incidence of hydrocephalus. METHODS:Population-based studies reporting prevalence of hydrocephalus were identified (MEDLINE, EMBASE, Cochrane, and Google Scholar (1985-2017)). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two authors reviewed abstracts, full text articles and abstracted data. Metanalysis and meta-regressions were used to assess associations between key variables. Heterogeneity and publication bias were assessed. Main outcome of interest was hydrocephalus prevalence among pediatric (≤ 18 years), adults (19-64 years), and elderly (≥ 65) patients. Annual hydrocephalus incidence stratified by country income level and folate fortification requirements were obtained (2003-2014) from the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). RESULTS:Of 2,460 abstracts, 52 met review eligibility criteria (aggregate population 171,558,651). Mean hydrocephalus prevalence was 85/100,000 [95% CI 62, 116]. The prevalence was 88/100,000 [95% CI 72, 107] in pediatrics; 11/100,000 [95% CI 5, 25] in adults; and 175/100,000 [95% CI 67, 458] in the elderly. The ICBDSR-based incidence of hydrocephalus diagnosed at birth remained stable over 11 years: 81/100,000 [95% CI 69, 96]. A significantly lower incidence was identified in high-income countries. CONCLUSION:This systematic review established age-specific global hydrocephalus prevalence. While high-income countries had a lower hydrocephalus incidence according to the ICBDSR registry, folate fortification status was not associated with incidence. Our findings may inform future healthcare resource allocation and study.