Barriers to Patients' Early Presentation, Diagnosis and Treatment in Childhood Hydrocephalus

A Quantitative and Qualitative Analysis of the Barriers to Patients' Early Presentation, Diagnosis and Treatment in Childhood Hydrocephalus

Patient with childhood hydrocephalus (HC) tend to present late in Low medium income countries (LMICs). This project will study the barriers leading to patients' and health system delay in patients with childhood HC. This will be done via a quantitative and qualitative study analysis. The data will be collected prospectively.

Study Overview

• Status: Completed
• Conditions: Hydrocephalus in Children
• Intervention / Treatment: Other: Hydrocephalus

Detailed Description

Children less than 5 years of age with HC confirmed with either magnetic resonance or computerized tomographic images will be recruited. In addition, Hospital staff members, who have been working within the Neurosurgical unit for at least 5 years will be interviewed.

The patients' data that will be collected will include gender, age at presentation, socioeconomic class of parents (or guardians), religion, referral source, presenting complaint with its duration, physical findings, ventricular diameter. The Pre-presentation symptoms interval (PPI) will be defined as the number of days between the onset of symptoms and first presentation at any type of healthcare service centre (including primary healthcare centre, secondary health institutions); Presentation Interval (PI)- Number of days from symptoms to presenting at Neurosurgical centre; Pre-diagnostic interval (PDI) will be defined as the interval in days between symptoms and completion of pre-operative investigations. Patient interval (PI) will be defined as the number of days from the onset of symptoms and patient's first contact with the Neurosurgical center. Hospital interval (HI)- number of days from completion of investigations to surgical intervention. The collected data will be analyzed according to qualitative conventional content analysis. Nvivo software version 13 and Statistical Product and Service Solutions (SPSS) version 23 will be used for data analysis.

• Study Type: Observational
• Enrollment (Actual): 100

Contacts and Locations

Study Locations

• Nigeria
  • Lagos
    • Ikeja, Lagos, Nigeria, 20001
      • Lagos State University Teaching Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 5 years (Child)
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Patients who present at the Lagos State University Teaching Hospital, Ikeja, Lagos for management of hydrocephalus

Description

Inclusion Criteria:

• All patients less than 5 years of age with HC confirmed with either magnetic resonance or computerized tomographic images
• Patients' parents' inclusion criteria will be parents (Guardians) of children with radiologically confirmed HC with either magnetic resonance or computerized tomographic images.
• Hospital staff members, who have been working within the Neurosurgical unit for at least 5 years.

Exclusion Criteria:

• All patents not investigated or operated at our centre
• Patients older than 5 years

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Patient Presentation time in days	Time in days, from the onset of symptoms to the time the patient seeks medical advice.	14 days
Diagnostic delay in days	Time in days between the patient's presentation and the confirmation of the diagnosis, in days	14 days
Treatment delay in days	The duration (in days) between the diagnosis and initiation of treatment	14 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment outcome as perceived by parents/caregivers	Effectiveness of the treatment in improving patient outcomes using a questionnaire (5-point Likert scale based survey questions with higher scores meaning better outcome)	4 weeks
Parents/caregivers satisfaction	The parent's satisfaction with the quality of care received using a questionnaire (5-point Likert scale based survey questions with higher scores meaning better outcome)	4 weeks
Reason for delay in presentation, diagnosis and treatment	As described by the parents and hospital staff	4 weeks

Collaborators and Investigators

• Sponsor: Lagos State University
• Collaborators: Hydrocephalus Association
• Investigators: Principal Investigator: Olufemi Idowu, FWACS, FACS, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2023
• Primary Completion (Actual): January 27, 2024
• Study Completion (Actual): January 27, 2024

Study Registration Dates

• First Submitted: March 7, 2023
• First Submitted That Met QC Criteria: April 1, 2023
• First Posted (Actual): April 3, 2023

Study Record Updates

• Last Update Posted (Estimated): December 15, 2025
• Last Update Submitted That Met QC Criteria: December 7, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Hydrocephalus
• Other Study ID Numbers: 2023/Hydro

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Anonymized data on request
• IPD Sharing Time Frame: Jan 2024 till Jan 2025
• IPD Sharing Access Criteria: via email
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No