World Journal of Surgery

, Volume 40, Issue 4, pp 806–812 | Cite as

Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana

  • Michael Ohene-Yeboah
  • Jessica H. Beard
  • Benjamin Frimpong-Twumasi
  • Adofo Koranteng
  • Samuel Mensah
Original Scientific Report



Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings.


Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment.


A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8 % (95 % CI 8.0, 13.6 %), and 2.2 % (95 % CI 0, 5.4 %) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0 % (95 % CI 10.2, 15.7 %). Prevalence of inguinal hernia increased with age; 35.4 % (95 % CI 23.6, 47.2 %) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socio-economic status. Of those with inguinal hernia, 52.4 % did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2 %).


Although inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society and could be adapted for use in other low-resource settings


Grant support

Ghana Universities Book and Research Allowance and personal funding.

Compliance with ethical standards

Conflict of interest

No conflicts of interest potential or real.


  1. 1.
    Sanders DL, Porter CS, Mitchell KCD, Kingsnorth A (2008) A prospective cohort study comparing the African and European hernia. Hernia 12:527–529CrossRefPubMedGoogle Scholar
  2. 2.
    Dl Sanders, Kingsnorth A (2007) Operation hernia: humanitarian hernia repairs in Ghana. Hernia 11:389–391CrossRefGoogle Scholar
  3. 3.
    Harouna Y, Yay H, Abdou I, Bazira I (2000) Prognosis of strangulated inguinal hernia in the adult: influence of intestinal necrosis. Bull-Soc-Pathol-Exost 93:317–320Google Scholar
  4. 4.
    Grimes CE, Bowman KG, Dodgion CM, Lavy CBD (2009) Systematic review of barriers to surgical care in low -income and middle –income countries. World J Surg 5:941–950Google Scholar
  5. 5.
    Grimes CE, Law RSL, Borgstein ES, Mkandawire NC, Lavy CBD (2012) Systematic review of met and unmet needs of surgical disease in rural sub-Saharan Africa. World J Surg 36:8–23CrossRefPubMedGoogle Scholar
  6. 6.
    Beard JH, Oresanya LB, Ohene-Yeboah M, Dicker RA, Harris HW (2013) Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana. World J Surg 37(3):498–503CrossRefPubMedGoogle Scholar
  7. 7.
  8. 8.
    Belcher DW, Nyame PK, Wurapa FK (1978) The prevalence of inguinal hernia in adult Ghanaian males. Trop Geogr Med 30:39–43PubMedGoogle Scholar
  9. 9.
  10. 10.
    National Health Insurance Policy Framework for Ghana. Revised Version. Ministry of Health August 2004Google Scholar
  11. 11.
    2010 Ghana Population and Housing census (phc) Final Results. Ghana Statistical Services may 2012.Selected age characteristics of the population.
  12. 12.
    Lofgren J, Makumbi F, Galiwango E, Nordin P et al (2014) Prevalence of treated and untreated groin hernia in eastern Uganda. BJS 101:728–734CrossRefGoogle Scholar
  13. 13.
    Primatesta P, Goldacre MJ (1996) Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 25:835–839CrossRefPubMedGoogle Scholar
  14. 14.
    Gyasi M, Amoako WMA, Asamany DK (2007) Barriers to cataract surgery uptake in the Upper East region of Ghana. Ghana Med J 41:167–17017PubMedCentralPubMedGoogle Scholar
  15. 15.
    Choo S, Perry H, Hesse A, Abantanga F, Sory E et al (2010) Assessment of capacity for surgery, obstetrics and anesthesia in 17 Ghanaian hospitals using World Health organization Assessment Tool. Trop Med Int Health 15:1109–1115PubMedGoogle Scholar
  16. 16.
    Abantanga FA, Hesse A, Sory E, Osen H, Choo S et al (2012) Policies for improving access to quality of basic and essential surgical care at district hospitals in Ghana. Post Grad Med J Ghana 1(1):3–8Google Scholar
  17. 17.
    Cumbi A, PereiraC Malalane R, Vaz F, McCord C et al (2007) Major surgery delegation to mid-level health practitioners in Mozambique: health professionals perceptions. Hum Resour Health 5:27PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Wilhelm TJ, Thawe IK, Mwatibu B, Mothes H, Post S (2011) Efficacy of major general surgery performed by non-physician clinicians at a central Hospital in Malawi. Trop Dr 21:71–75CrossRefGoogle Scholar
  19. 19.
    Beard JH, Oresanya LB, Akoko L, Mwanga A, Mkony CA, Dicker RA (2014) Surgical task-shifting in a low-income resource setting: outcomes after major surgery performed by non-physician clinicians in Tanzania. World J Surg 38(6):1398–14041CrossRefPubMedGoogle Scholar
  20. 20.
  21. 21.
    Source: District Health Management Team (DHTM), GhanaGoogle Scholar
  22. 22.
    Ghana Hernia Society
  23. 23.
  24. 24.
    Remme JHF, Feenstra P, P. R. Lever RAND Corporation (1983) Conceptualization and measurement of physiologic health of adults. RAND Corporation, Santa Monica, CAGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Michael Ohene-Yeboah
    • 1
  • Jessica H. Beard
    • 2
  • Benjamin Frimpong-Twumasi
    • 3
  • Adofo Koranteng
    • 4
  • Samuel Mensah
    • 5
  1. 1.Department of Surgery, School of Medicine and Dentistry, College of Health Sciences (Korle-Bu teaching Hospital)University of GhanaLegon, AccraGhana
  2. 2.Division of Trauma, Penn Presbyterian Medical CenterSurgical Critical Care & ESSPhiladelphiaUSA
  3. 3.Department of SurgeryKomfo Anokye Teaching HospitalKumasiGhana
  4. 4.Department of Community HealthKwame Nkrumah University of Science and TechnologyKumasiGhana
  5. 5.Department of SurgeryKumasi Regional HospitalKumasiGhana

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