title: Prevalence of Inguinal Hernia in Adult Men in the Ashanti Region of Ghana.
abstract: BACKGROUND
  Inguinal hernia is thought to be common in rural Ghana, though no recent data exist on hernia prevalence in the country. This information is needed to guide policy and increase access to safe hernia repair in Ghana and other low-resource settings.
  
  
  METHODS
  Adult men randomly selected from the Barekese sub-district of Ashanti Region, Ghana were examined by surgeons for the presence of inguinal hernia. Men with hernia completed a survey on demographics, knowledge of the disease, and barriers to surgical treatment.
  
  
  RESULTS
  A total of 803 participants were examined, while 105 participants completed the survey. The prevalence of inguinal hernia was 10.8 % (95 % CI 8.0, 13.6 %), and 2.2 % (95 % CI 0, 5.4 %) of participants had scars indicative of previous repair, making the overall prevalence of treated and untreated inguinal hernia 13.0 % (95 % CI 10.2, 15.7 %). Prevalence of inguinal hernia increased with age; 35.4 % (95 % CI 23.6, 47.2 %) of men aged 65 and older had inguinal hernia. Untreated inguinal hernia was associated with lower socio-economic status. Of those with inguinal hernia, 52.4 % did not know the cause of hernia. The most common reason cited for failing to seek medical care was cost (48.2 %).
  
  
  CONCLUSIONS
  Although inguinal hernia is common among adult men living in rural Ghana, surgical repair rates are low. We propose a multi-faceted public health campaign aimed at increasing access to safe hernia repair in Ghana. This approach includes a training program of non-surgeons in inguinal hernia repair headed by the Ghana Hernia Society and could be adapted for use in other low-resource settings.
authors.affiliation: Department of Surgery, School of Medicine and Dentistry, College of Health Sciences (Korle-Bu teaching Hospital), University of Ghana, Legon, Accra, Ghana. mikeoheneyeboah@yahoo.co.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Ohene-Yeboah
authors.affiliation: Division of Trauma, Penn Presbyterian Medical Center, Surgical Critical Care & ESS, 51 N. 39th Street, Medical Office Bldg, 1st Floor, Suite 120, Philadelphia, PA, 19104, USA.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Beard
authors.affiliation: Department of Surgery, Komfo Anokye Teaching Hospital, PO Box 1934, Kumasi, Ghana.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Frimpong-Twumasi
authors.affiliation: Department of Community Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Adofo
authors.initials: A
authors.lastname: Koranteng
authors.affiliation: Department of Surgery, Kumasi Regional Hospital, Kumasi, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Mensah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002921:Cicatrix; D003365:Costs and Cost Analysis; D005869:Ghana / Q000453:epidemiology; D005102:Health Expenditures; D006285:Health Planning; D006291:Health Policy; D006293:Health Promotion; D006295:Health Resources; D006297:Health Services Accessibility; D006552:Hernia, Inguinal / Q000191:economics / Q000453:epidemiology* / Q000601:surgery; D059685:Herniorrhaphy / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult