W. T. Chendjou3, S. A. Christie1, M. M. Carvalho1, T. Nana4, E. Wepngong3, D. Dickson1, R. Dicker2, A. Chichom Mefire3, C. Juillard1 1University Of California – San Francisco,Department Of Surgery,San Francisco, CA, USA 2University Of California – Los Angeles,Department Of Surgical Critical Care,Los Angeles, CA, USA 3University of Buea,Faculty Of Health Sciences,Buea, SOUTHWEST, Cameroon 4Regional Hospital Limbe,Department Of Surgery,Limbe, SOUTHWEST, Cameroon
Introduction: Hernias are one of the most commonly encountered surgical conditions, and every year, more than 20 million hernia repairs are performed worldwide. The surgical management of hernia, however, is largely neglected as a public health priority in developing countries, despite its cost-effectiveness. To date, the prevalence and impact of hernia has not been formally studied in a community setting in Cameroon. The aim of this study was to determine the prevalence and characteristics of untreated hernia in the Southwest region of Cameroon.
Methods: This study was a sub-analysis of a cross-sectional community-based survey on injury in Southwest Cameroon. Households were sampled using a three-stage cluster sampling method. Household representatives were asked to identify all untreated hernias occurring in the past year. Data on socio-economic factors, hernia symptoms – including the presence of hernia incarceration- and treatment attempts were collected between January 2017 and March 2017.
Results: Among 8065 participants, 73 persons reported symptoms of untreated hernia, resulting in an overall prevalence of 7.4 cases per 1000 persons (95% CI: 4.98-11.11). Groin hernias were most commonly reported (n=49, 67.1%) and predominant in young adult males. Over half of persons with untreated hernia reported having symptoms of incarceration (52.1%, n=38), yet 42.1% of these participants did not receive any surgical treatment. Moreover, 21.9 % (n=16) of participants with untreated hernias never presented to formal medical care, primarily due to the high-perceived cost of care. Untreated hernias caused considerable disability as 21.9 % of participants were unable to work due to their symptoms and 15.1% of households earned less money.
Conclusion: Hernia is a significant surgical problem in Southwest, Cameroon. Despite over half of persons with unrepaired hernias reporting symptoms of incarceration, home treatment and non-surgical management was common. Costs associated with formal medical services are a major barrier to obtaining consultation and repair. Greater awareness of hernia complications and cost restructuring should be considered to prevent disability and mortality due to hernia.