Evaluation of academic performance and social integration of children operated for hydrocephalus in Cameroon.

Abstract

Low intelligence quotient (IQ) and delayed psychomotor development (DPD) are formidable complications of hydrocephalus. The aim of this study was to evaluate the academic performance and social integration of children operated on for hydrocephalus in Cameroon. The authors present a cross-sectional study with retrospective data collection from January 2010 to May 2020. All children less than 10years of age who had undergone surgery for a ventriculo-peritoneal shunt indicated for hydrocephalus with a post-operative evolution of 7 to 10years and who were attending school were included. Academic performance was assessed using the Wechsler Intelligence Scale for Children IV (WISC IV), and social integration was assessed using the Vineland II score. Of the 45 children aged 7 to 10years who attended school and were followed-up, the sex ratio was 1.25 in favor of males. 77.8% of these children had a malformation with paralysis being the most common functional sequela (29%). 73.3% of our patients had good social integration. Fifty-three percent of patients had reduced academic performance, with non-verbal performance being the most frequent (62.2%). Long-term memory was the most impaired, with 73.3% having a very low speed of information processing. Non-verbal performance was the most affected (62.2%) particularly long-term memory. Forty percent had an IQ below 70. The statistically significant determinants of social integration were age, sex, malformative etiology, and good psychomotor development, and the statistically significant determinants of educational delay were age, malformative etiology, IQ below 70, and time to care. Academic performance was reduced in more than half of our patients, but most of them had good social integration. Early diagnosis and management improve the chances of good psychomotor development and IQ.