Is VP Shunt Infection Still a Threat? Clinical Burden and Outcomes of Paediatric Ventriculoperitoneal Shunts in Tanzania

BACKGROUND The mainstay treatment for patients with hydrocephalus is surgical, with VPS placement being a routine practice in hospitals with limited resources and workforce. However, VP shunt-related infections continue to exert a significant clinical and economic burden, particularly in low-resource settings such as Tanzania; where infection control infrastructure may be limited. Despite advances in surgical technique and perioperative care, the persistence of these infections raises critical concerns regarding outcomes and system preparedness. METHODS A cohort study was carried out at a tertiary hospital from 2020 to 2023. It included 263 patients who underwent initial VPS surgeries. Postoperatively, the patients had routine follow-up care for three months, at which time their characteristics in relation to post-operative VP shunt infections were evaluated. SPSS version 26 was utilized for analyzing the data that had been gathered. RESULTS A total of 263 pediatric patients underwent VP shunt procedures at a tertiary hospital in northern Tanzania. Most were aged ≤ 5 years (56.3%), with increased head size (74.9%) and fever (42.2%) as common symptoms. VP shunt infections occurred in 23.2% of cases, with children aged ≤ 5 years (OR = 1.87, p = 0.043) and those with ASA score III (AOR = 5.34, 95% CI: 2.02–14.1, p = 0.001) being at higher risk. Shunt revisions were performed in 35.7% of patients, and 35.0% experienced prolonged hospital stays. Staphylococcus aureus (22.2%) was the most frequent isolate. These findings underscore the ongoing burden of shunt infections and highlight the importance of early risk identification and improved perioperative care in pediatric neurosurgery. CONCLUSION Yes, VPS infections remain a significant threat in pediatric patients in northern Tanzania, with infection rates reaching 27% in children five years and younger. These infections contribute to serious clinical and resource challenges. Children with poorer preoperative health were over five times more likely to develop infections, emphasizing the vulnerability of this group. These findings highlight the urgent need to improve infection prevention and perioperative care to reduce complications and improve outcomes in this resource-limited setting.