Epidemiology of hydrocephalus in Brazil

Abstract

Objective: Describe the epidemiological profile and social-economic burden that hydrocephalus patients represent to the national public health system, using data available at the online database of the Brazilian Health Ministry (DataSUS).

Methods: This is a populational study based on descriptive statistics of all clinical and surgical appointments included in the DataSUS database. Data included herein were collected between 2015 and 2021 and subdivided into three main groups, related to hydrocephalus incidence and mortality, hospitalizations, and financial costs.

Results: In the study period, 3993 new cases of congenital hydrocephalus were diagnosed, with 6051 deaths overall. The mortality rate in the country was 1.5/100000 live births and the prevalence was 0.374/100000 inhabitants. The number of hospitalizations resulting from treatment procedures and complications of hydrocephalus was 137,880 and there was a reduction of up to 27.2% during the SARS-CoV-2 pandemics concerning previous years. Total costs for hydrocephalus management in the country amounted to 140,610,585.51 dollars.

Conclusions: Hydrocephalus has a significant impact on public health budgets and pediatric mortality rates; however, it is probably underestimated, due to the paucity of demographic data and epidemiological studies in Latin America and, specifically, in Brazil. The dataSUS also has several limitations in accessing certain data related to hydrocephalus, making it difficult to have a more assertive understanding of the disease in Brazil. The results of this study provide important guidance for future research projects in clinical and experimental hydrocephalus and also the creation of public policies for better governance and care of hydrocephalus patients.

Keywords: Epidemiology; Hydrocephalus; National registry.

Fig. 1

Flowchart of the strands and their access in DataSUS. Based on each aspect, diagnoses were used according to their main categories and subcategories according to the ICD-10 classification.

Fig. 2

Number of hydrocephalus cases available in dataSUS by Brazilian region from 2015 to 2019. N: North, NE: Northeast, SE: Southeast, S: South and CO: Midwest. The SE (37.5%) and NE (30.8%) regions had the highest number of cases in the period evaluated and the CO region had the lowest rates. (Ministry of Health - Live Births Information System - SINASC).

Fig. 3

Total number of deaths from hydrocephalus and congenital hydrocephalus by Brazilian region from 2015 to 2019. N: North, NE: Northeast, SE: Southeast, S: South and CO: Midwest. The SE (38.6%) and NE (30.4%) regions were the ones with the highest number of deaths from hydrocephalus and congenital hydrocephalus in the studied period, according to DataSUS (Ministry of Health - Live Births Information System - SINASC).

Fig. 4

Hospitalizations for treatment procedures and complications of hydrocephalus from 2015 to 2021. N: North, NE: Northeast, SE: Southeast, S: South and CO: Midwest. It is noted that the SE and NE regions had the highest hospitalization rates and the N region had the lowest. (Ministry of Health - Live Births Information System - SINASC).