title: Rainfall drives hydrocephalus in East Africa.
abstract: OBJECTIVE
  Hydrocephalus is one of the most common brain disorders in children throughout the world. The majority of infant hydrocephalus cases in East Africa appear to be postinfectious, related to preceding neonatal infections, and are thus preventable if the microbial origins and routes of infection can be characterized. In prior microbiological work, the authors noted evidence of seasonality in postinfectious hydrocephalus (PIH) cases.
  
  
  METHODS
  The geographical address of 696 consecutive children with PIH who were treated over 6 years was fused with satellite rainfall data for the same time period. A comprehensive time series and spatiotemporal analysis of cases and rainfall was performed.
  
  
  RESULTS
  Four infection-onset peaks were found to straddle the twice-yearly rainy season peaks, demonstrating that the infections occurred at intermediate levels of rainfall.
  
  
  CONCLUSIONS
  The findings in this study reveal a previously unknown link between climate and a neurosurgical condition. Satellite-derived rainfall dynamics are an important factor in driving the infections that lead to PIH. Given prior microbial analysis, these findings point to the importance of environmental factors with respect to preventing the newborn infections that lead to PIH.
authors: Center for Neural Engineering and Department of Engineering Science and Mechanics, The Pennsylvania State University, University Park, PA, USA. sschiff@psu.edu
authors: Steven J
authors: SJ
authors: Schiff
authors: Sylvia L
authors: SL
authors: Ranjeva
authors: Timothy D
authors: TD
authors: Sauer
authors: Benjamin C
authors: BC
authors: Warf
mesh_terms: D000351:Africa, Eastern / Q000453:epidemiology; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006849:Hydrocephalus / Q000191:economics / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000601:surgery; D007223:Infant; D007239:Infections / Q000150:complications*; D008297:Male; D011891:Rain; D012307:Risk Factors; D012621:Seasons; D014329:Tropical Climate / Q000009:adverse effects*; D014454:Uganda / Q000453:epidemiology