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.
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
100
Interview
Lagos State University Teaching Hospital
Ikeja, Lagos, Nigeria
Patient Presentation time in days
Time in days, from the onset of symptoms to the time the patient seeks medical advice.
Time frame: 14 days
Diagnostic delay in days
Time in days between the patient's presentation and the confirmation of the diagnosis, in days
Time frame: 14 days
Treatment delay in days
The duration (in days) between the diagnosis and initiation of treatment
Time frame: 14 days
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)
Time frame: 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)
Time frame: 4 weeks
Reason for delay in presentation, diagnosis and treatment
As described by the parents and hospital staff
Time frame: 4 weeks
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