title: The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa.
abstract: BACKGROUND
  The burden of disease and mortality associated with inguinal hernia in Africa, especially in sub-Saharan Africa, is very high. The purpose of this study is to show that International Cooperation work in the field of hernia repair is effective; it minimizes the delay in hernia repairs in the targeted population, and can prevent a large number of disability-adjusted life years (DALYs).
  
  
  METHODS
  As a part of an International Cooperation program, a total of 990 black patients with inguinal hernias were studied, in whom hernioplasty was performed using polypropylene mesh. The type of hernia and surgical technique were studied. Indicators of scientific and technical quality, indicators of efficiency and of effectiveness were analyzed. The results on the usefulness of interventions were calculated as avoided DALYs.
  
  
  RESULTS
  Surgery was performed on 926 patients with a total of 1033 hernia repairs. 87.2 % of the repairs were made with mesh. There was no mortality in the series, complications were minor, and 85.7 % of patients remained less than 24 h in the center. There was a 2.8 % of recurrence, with a follow-up 58.7 % of the patients in the first year. 5014 DALYs were avoided, and the average of the avoided DALYs per patient was of 5.41.
  
  
  CONCLUSIONS
  Hernia repair with mesh in low development countries is a procedure with low morbidity and high effectiveness that can prevent a large number of DALYs.
authors.affiliation: Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain. ciranito@telefonica.net.
authors.forename: José
authors.initials: J
authors.lastname: Gil
authors.affiliation: Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Rodriguez
authors.affiliation: Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gil
authors.affiliation: Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: Q
authors.initials: Q
authors.lastname: Hernández Agúera
authors.affiliation: Surgery, Hospital Universitario Reina Sofía, Córdoba, Spain.
authors.forename: F M
authors.initials: FM
authors.lastname: González
authors.affiliation: Anesthesia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: García
authors.affiliation: Surgery, Hospital Universitario Santa Lucía, Cartagena, Murcia, Spain.
authors.forename: M D
authors.initials: MD
authors.lastname: Balsalobre
authors.affiliation: Anesthesia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Tortosa
authors.affiliation: Nursing, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Hernández Palazón
authors.affiliation: Surgery, Sikasso Hospital, Sikasso , Mali.
authors.forename: A B
authors.initials: AB
authors.lastname: Diallo
authors.affiliation: Surgery, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Parrilla
mesh_terms: D017954:Africa South of the Sahara; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D013526:Surgical Mesh