Prevalence of Hydrocephalus Among Children Under Five Admitted to Edna Adan Hospital, Hargeisa, Somaliland: A Five-year Retrospective Study

Abstract Background In sub-Saharan Africa, hydrocephalus—a condition characterized by abnormal cerebrospinal fluid (CSF) accumulation that causes ventricular expansion—occurs often. Its burden is increased by high infection rates, delayed diagnosis, and restricted access to neurosurgery. Over a five-year period, this study aimed to evaluate the prevalence, sociodemographic, and etiologies of hydrocephalus in children under five who were admitted to Edna Adan Hospital in Hargeisa, Somaliland. Methods A retrospective assessment of records was carried out between 2020 and 2024, examining 266 cases that were chosen using simple random sampling. A systematic checklist was used to capture data on age, gender, year of admission, and the causes of hydrocephalus (congenital, acquired, communicative, non-communicating, and unknown). SPSS version 25 was then used for analysis after being checked by trained data collectors. Distributions and relationships were assessed using chi-square tests, cross-tabulations, and descriptive statistics. Results 91.40% of occurrences occurred in infants between the ages 0–12 months, with females accounting for the majority (50.40%). Congenital hydrocephalus accounted for the majority (62.0%), followed by acquired causes (12.40%) and unknown causes (18.80%). Between 2020 and 2024, the number of admissions decreased from 72 to 49. The year of admission and aetiology (p = 0.012) and age and aetiology (p = 0.002) showed significant correlations, but not gender (p = 0.936). Conclusion This study emphasizes Somaliland's congenital dominance and early infancy onset of hydrocephalus, with falling trends that may be related to better prenatal care. In areas with limited resources, improved neurosurgical capabilities, early screening, and diagnostic tools are crucial for addressing unidentified cases and minimizing morbidity.