Barriers to inguinal hernia repair in Ghana: prospective, multi-centre cohort study

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Barriers to inguinal hernia repair in Ghana: prospective, multi-centre cohort study


JournalJournal of Medical and Biomedical Sciences
Article typeJournal research article – Clinical research
Publication date – Nov – 2020
Authors – Abass Alhassan, Francis Atidana Abantanga, Omar Omar, Dmitri Nepogodiev, Aneel Bhang, Saeed F. Majeed, Kwame Opare-Asamoah, Michael Ohene Yeboah, Stephen Tabiri
KeywordsHernia repair, inguinal hernia, Kingnorth’s classification of inguinal hernia, Poverty
Open access – Yes
SpecialityGeneral surgery
World region Western Africa
Country: Ghana
Language – English
Submitted to the One Surgery Index on January 2, 2021 at 1:45 am
Abstract:

Inguinal hernia (IH) is the most common general surgical pathology in Ghana with hernia repair rate very low. The objective was to assess patient-perceived barriers to IH repair in Ghana and identify predictors of experiencing delays until surgery. A multicenter prospective study was conducted during the Ghana Hernia Society outreach. Data regarding diagnosis using Kingsnorth’s classification of IH, age of patients, duration of hernia, reason for delay in repair, insurance status, American Society of Anesthesiologists (ASA) class, travel distance, region, hospital, and waiting times were obtained from patients and folders. Multivariable linear regression models were constructed to analyze delay until surgery and Kingsnorth’s classification while controlling for the covariates of age, insurance status, ASA class among others. The most common reasons were queues for surgery (23%), poverty (10%), and seeking traditional medicine (9%). On multivariate linear regression, increasing age and ASA class III were predictors of longer delays. Patients experienced significant increase of 1.1 years delay to surgery for every 10 year increase in of age. ASA Class III patients were significantly more likely to be delayed by 11.5 years compared to ASA Class I patients. Efforts should be made to address and overcome the barriers to IH repair identified.

OSI Number – 20826

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