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An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania

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Abstract

Purpose

Surgical conditions represent a significant source of global disease burden. Little is known about the epidemiology of inguinal hernia in resource-poor settings. We present a method to estimate inguinal hernia disease burden in Tanzania.

Methods

Using data from the United States National Health and Nutrition Examination Survey (NHANES) prospective cohort study and Tanzanian demographic figures, we calculated inguinal hernia incidence and prevalence in Tanzanian adults under three surgical rate scenarios. Gender-specific incidence figures from NHANES data were adjusted according to Tanzanian population age structure. Hernia duration was adjusted for Tanzanian life expectancy within each age group.

Results

The prevalence of inguinal hernia in Tanzanian adults is 5.36 % while an estimated 12.09 % of men had hernias. Today, 683,904 adults suffer from symptomatic inguinal hernia in Tanzania. The annual incidence of symptomatic hernias in Tanzanian adults is 163 per 100,000 population. At Tanzania’s current hernia repair rate, a backlog of 995,874 hernias in need of repair will develop over 10 years. 4.4 million disability-adjusted life-years would be averted with repair of prevalent symptomatic hernias in Tanzania.

Conclusions

Our data indicate the extent of inguinal hernia disease burden in Tanzania. By adjusting our figures for the age structure of Tanzania, we have demonstrated that while the incidence of symptomatic cases may be lower than previously thought, prevalence of inguinal hernia in Tanzania remains high. This approach provides an update to our previously described methodology for calculation of inguinal hernia epidemiology in resource-poor settings that may be used in multiple country contexts.

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References

  1. Debas HT, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT, Brennan JG, Measham AR et al (eds) Disease control priorities in developing countries, 2nd edn. Oxford University Press, New York, pp 1245–1260

    Google Scholar 

  2. Luboga S, Macfarlane SB, von Schreeb J et al (2009) Increasing access to surgical services in sub-Saharan Africa: priorities for national and international agencies recommended by the Bellagio Essential Surgery Group. PLoS Med 6(12):e1000200

    Article  PubMed Central  PubMed  Google Scholar 

  3. Kingsnorth A, LeBlanc K (2003) Hernias: inguinal and incisional. Lancet 362(9395):1561–1571

    Article  PubMed  Google Scholar 

  4. Everhart JE Abdominal wall hernia (1994) In: Everhart JE (ed) Digestive diseases in the United States: epidemiology and impact. National Institute of Diabetes, Digestive and Kidney Diseases, Bethesda, pp 471–507

  5. Yardov YS, Stoyanov SK (1969) The incidence of hernia on the island of Pemba. East Afr Med J 46:687–691

    Google Scholar 

  6. Shillcutt SD, Clarke MG, Kingsnorth AN (2010) Cost-effectiveness of groin hernia surgery in the western Region of Ghana. Arch Surg 145:954–961

    Article  PubMed  Google Scholar 

  7. Ohene-Yeboah M, Abantanga F, Oppong J et al (2009) Some aspects of the epidemiology of external hernia in Kumasi, Ghana. Hernia 13:529–532

    Article  PubMed  CAS  Google Scholar 

  8. Rutkow IM (2003) Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin N Am 83(5):1045–1051

    Article  PubMed  Google Scholar 

  9. Grimes CE, Law RS, Borgstein ES et al (2012) Systematic review of met and unmet need of surgical disease in rural sub-saharan Africa. World J Surg 36(1):8–23

    Article  PubMed  Google Scholar 

  10. Nordberg E (1984) Incidence and estimated need of cesarean section, inguinal hernia repair, and operation for strangulated hernia in rural Africa. BMJ (Clin Res Ed) 289(6437):92–93

    Article  CAS  Google Scholar 

  11. Beard JH, Oresanya LB, Ohene-Yeboah M et al (2012) Characterizing the global burden of surgical disease: a method to estimate inguinal hernia epidemiology in Ghana. World J Surg. doi:10.1007/s00268-012-1864-x

    Google Scholar 

  12. Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165(10):1154–1161

    Article  PubMed  Google Scholar 

  13. Anonymous (2012) United States Census Bureau: International Database. http://www.census.gov/population/international/data/idb/region.php.census.gov/population/international/data/idb/region.php. Accessed 15 Dec 2012

  14. Anonymous (2012) World Health Organization: life tables for WHO member states. http://www.who.int/healthinfo/statistics/mortality_life_tables/en. Accessed 15 Dec 2012

  15. Hair A, Paterson C, Wright D et al (2001) What effect does the duration of an inguinal hernia have on patient symptoms? J Am Coll Surg 193:125–129

    Article  PubMed  CAS  Google Scholar 

  16. Neuhauser D (1977) Elective inguinal herniorrhaphy versus truss in the elderly. In: Bunker JP, Barnes BA, Mosteller F (eds) Costs, risks, and benefits of surgery. Oxford University Press, New York, pp 223–239

    Google Scholar 

  17. Ohene-Yeboah M (2003) Strangulated external hernias in Kumasi Ghana. West Afr J Med 220:310–313

    Google Scholar 

  18. Ohene-Yeboah M, Abantanga FA (2011) Inguinal hernia disease in Africa: a common but neglected surgical condition. West Afr J Med 30(2):77–83

    PubMed  CAS  Google Scholar 

  19. Harouna Y, Yaya H, Abdou I, Bazira L (2000) Prognosis of strangulated inguinal hernia in the adult: influence of intestinal necrosis. A propos of 34 cases. Bull Soc Pathol Exot 93:317–320

    PubMed  CAS  Google Scholar 

  20. McConkey SJ (2002) Case series of acute abdominal surgery in rural Sierra Leone. World J Surg 26:509–513

    Article  PubMed  Google Scholar 

  21. Shillcutt S, Sanders L, Butron-Vila MT, Kingsnorth AN (2012) Cost-effectiveness of inguinal hernia surgery in northwestern Ecuador. World J Surg. doi:10.1007/s00268-012-1808-5

    Google Scholar 

  22. Shillcutt SD, Clarke MG, Kingsnorth AN (2010) Cost-effectiveness of groin hernia surgery in the western region of Ghana. Arch Surg 145:954–961

    Article  PubMed  Google Scholar 

  23. Zendejas B, Ramirez T, Jones T et al (2013) Incidence of inguinal hernia repairs in Olmsted County, MN: a population based study. Ann Surg 257(3):520–526

    Article  PubMed Central  PubMed  Google Scholar 

  24. Primatesta P, Goldacre MJ (1996) Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 25:835–839

    Article  PubMed  CAS  Google Scholar 

  25. Flemming AS, Burney L, Linder FE et al (1960) Health Statistics from the US National Health Survey: hernias reported in interviews. United States July 1957–June 1959. Washington DC, pp 1–19

  26. Lau H, Fang C, Yuen WK, Patil NG (2007) Risk factors for inguinal hernia in adult males: a case–control study. Surgery 141(2):262–266

    Article  PubMed  Google Scholar 

  27. Carbonell JF, Sanchez JL, Peris RT et al (1993) Risk factors associated with inguinal hernias: a case control study. Eur J Surg 159:481–486

    PubMed  CAS  Google Scholar 

  28. Abramson JH, Gofin J, Hopp C, Makler A, Epstein LM (1978) The epidemiology of inguinal hernia: a survey in western Jerusalem. J Epidemiol Community Health 32(1):59–67

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  29. Murray CJL, Vos T, Lozano R et al (2012) Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990–2010: a systematic analysis for the global burden of disease study 2010. Lancet 380:2197–2223

    Article  PubMed  Google Scholar 

  30. Anonymous (2012) CIA the World Factbook: Country Comparison Population Growth Rate. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2002rank.html. Accessed 21 Dec 2012

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Acknowledgements

We would like to acknowledge our funding source, the UCSF Department of Surgery.

Conflict of interest

JB, LO, LA, AM, RD, and HH declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, University of California San Francisco, 513 Parnassus Avenue S-321, San Francisco, CA, 94143, USA

    J. H. Beard, L. B. Oresanya, R. A. Dicker & H. W. Harris

  2. Department of Surgery, Muhimbili University of Health and Allied Sciences, PO Box 65007, Dar es Salaam, Tanzania

    L. Akoko & A. Mwanga

Authors
  1. J. H. Beard
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  2. L. B. Oresanya
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  3. L. Akoko
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  4. A. Mwanga
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  5. R. A. Dicker
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  6. H. W. Harris
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Corresponding author

Correspondence to J. H. Beard.

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Beard, J.H., Oresanya, L.B., Akoko, L. et al. An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania. Hernia 18, 289–295 (2014). https://doi.org/10.1007/s10029-013-1177-5

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  • DOI: https://doi.org/10.1007/s10029-013-1177-5

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