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. 2023 Jan 6;7(1):zrac158.
doi: 10.1093/bjsopen/zrac158.

Prevalence, incidence, repair rate, and morbidity of groin hernias in Sierra Leone: cross-sectional household study

Karel C Lindenbergh  1 , Alex J van Duinen  2   3   4 , Johan G Ahlbäck  3 , Joseph Kamoh  4 , Silleh Bah  5 , Thomas Ashley  4   6 , Jenny Löfgren  7 , Martin P Grobusch  8   9   10   11   12 , Osman Sankoh  5   13   14 , Håkon A Bolkan  2   3   4 ; PRESSCO 2020 study group
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Prevalence, incidence, repair rate, and morbidity of groin hernias in Sierra Leone: cross-sectional household study

Karel C Lindenbergh et al. BJS Open. .

Abstract

Background: Knowledge about the prevalence of groin hernias in sub-Saharan Africa is limited. Previous studies have demonstrated a higher incidence of the condition than the annual repair rate. This study aimed to investigate prevalence, incidence, annual repair rate, morbidity, and health-seeking behaviour of persons with groin hernias in Sierra Leone.

Methods: This population-based, cross-sectional household survey on groin hernias in Sierra Leone was part of the Prevalence Study on Surgical Conditions 2020 (PRESSCO 2020). Those who indicated possible groin hernia were asked problem-specific questions and underwent physical examination to confirm or exclude the diagnosis.

Results: 3626 study participants were interviewed. The prevalence of untreated groin hernia was 1.1 per cent (95 per cent c.i. 0.8 to 1.5 per cent), whereas the prevalence of untreated and treated groin hernia was 2.5 per cent (95 per cent c.i. 2.0 to 3.0 per cent). The proportion of recurrence was 13.1 per cent. An incidence of 389 (95 per cent c.i. 213 to 652) groin hernia cases per 100 000 people per year was identified, while a population-based annual hernia repair rate estimation was 470 (95 per cent c.i. 350 to 620) per 100 000 people. Out of 39 participants with groin hernia, non-ignorable pain was reported by eight and 27 reported financial shortcomings as a reason for not seeking healthcare.

Conclusions: Groin hernias are common in Sierra Leone and although the repair rate might match the incidence, the existing backlog of untreated hernias is likely to remain. It may be possible to reduce the number of recurrences through improved management. Measures to reduce financial barriers to treatment seem crucial to improve the health of people with groin hernias in Sierra Leone.

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Figures

Fig. 1
Fig. 1
Flow chart of selection of study participants
Fig. 2
Fig. 2
Three scenarios showing the effect of different groin hernia repair rates on prevalence of groin hernia among Sierra Leone people in 10 years All scenarios were corrected for an annual population growth of 2.14 per cent, which is equal to the population growth of Sierra Leone in 2018.
See this image and copyright information in PMC

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