title: Gross hematuria and urinary retention among men from a nationally representative survey in Sierra Leone.
abstract: OBJECTIVE
  To estimate the prevalence of gross hematuria and urinary retention among men in Sierra Leone and report on barriers to care and associated disability. Gross hematuria and urinary retention are classic urologic complaints that require medical attention for significant underlying pathology, but their burden has not been quantified in a developing country.
  
  
  METHODS
  A cluster randomized, cross-sectional household survey was administered in Sierra Leone using the Surgeons OverSeas Assessment of Surgical need tool as a verbal head-to-toe examination. A total of 2 respondents in each of 25 households in 75 clusters were surveyed to assess surgical needs. Data on questions related to blood from the penis and the inability to urinate for men>12 years were included in the present analysis to determine the period and point prevalence of hematuria and urinary retention.
  
  
  RESULTS
  From 3645 total respondents, 1054 (28.9%) were men>12 years included in the analysis. Period and point prevalence of gross hematuria were 21.8 per 1000 (95% confidence interval [CI] 13.0-30.7) and 12.3 per 1000 (95% CI 5.7-19.0), respectively, and for urinary retention, they were 19.9 per 1000 (95% CI 11.5-28.4) and 4.7 per 1000 (95% CI 0.5-8.9), respectively. Lack of financial resources was the major barrier to care. Disability assessment showed 19.1% were not able to work as a result of urinary retention, and 34.8% felt ashamed of their gross hematuria.
  
  
  CONCLUSIONS
  The results provide a prevalence estimate of gross hematuria and urinary retention for men in Sierra Leone. Accessible medical and surgical care will be critical for early intervention and management.
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD; Epidemiology and Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Electronic address: hitenpatel@jhmi.edu.
authors.forename: Hiten D
authors.initials: HD
authors.lastname: Patel
authors.affiliation: College of Medicine and Allied Health Science, Freetown, Sierra Leone; Department of Surgery, Connaught Hospital, Freetown, Sierra Leone; University of Sierra Leone, Freetown, Sierra Leone.
authors.forename: Thaim B
authors.initials: TB
authors.lastname: Kamara
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Surgery, Columbia University, New York, NY; Surgeons OverSeas (SOS), New York, NY.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Kushner
authors.affiliation: Surgeons OverSeas (SOS), New York, NY; Department of International Health, Royal Tropical Institute, Amsterdam, NL, The Netherlands; Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD.
authors.forename: Reinou S
authors.initials: RS
authors.lastname: Groen
authors.affiliation: James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD.
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
mesh_terms: D000328:Adult; D001294:Attitude to Health; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D003906:Developing Countries; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006417:Hematuria / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D018570:Risk Assessment; D012807:Sierra Leone / Q000453:epidemiology; D012959:Socioeconomic Factors; D016055:Urinary Retention / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
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