2023-09-28 14:46:10 +00:00
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abstract: 'Background: Herniorrhaphy is one of the most frequently performed
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general surgical operations worldwide. However, most low- and
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middle-income countries (LMICs) are unable to provide this essential
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surgery to the general public, resulting in considerable morbidity and
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mortality. This study aimed to estimate the prevalence, barriers to care
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and disability of untreated hernias in Nepal. Methods: Nepal is a
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low-income country in South Asia with rugged terrain, infrastructure
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deficiencies and a severely under-resourced healthcare system resulting
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in substantial unmet surgical need. A cluster randomized,
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cross-sectional household survey was performed using the validated
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Surgeons OverSeas Assessment of Surgical (SOSAS) tool. Fifteen
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randomized clusters consisting of 30 households with two randomly
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selected respondents each were sampled to estimate surgical need. The
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prevalence of and disability from groin hernias and barriers to
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herniorrhaphy were assessed. Results: The survey sampled 1350
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households, totaling 2695 individuals (97\% response rate). There were
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1434 males (53\%) with 1.5\% having a mass or swelling in the groin at
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time of survey (95\% CI 1.8-4.0). The age-standardized rate for inguinal
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hernias in men ranged from 1144 per 100,000 persons between age 5 and 49
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years and 2941 per 100,000 persons age >= 50 years. Extrapolating
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nationally, there are nearly 310,000 individuals with groin masses and
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66,000 males with soft/reducible groin masses in need of evaluation in
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Nepal. Twenty-nine respondents were not able to have surgery due to lack
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of surgical services (31\%), fear or mistrust of the surgical system
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(31\%) and inability to afford care (21\%). Twenty percent were unable
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to work as previous or perform self-care due to their hernia.
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Conclusions: Despite the lower than expected prevalence of inguinal
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hernias, hundreds of thousands of people in Nepal are currently in need
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of surgical evaluation. Given that essential surgery is a necessary
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component in health systems, the prevalence of inguinal hernias and the
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cost-effectiveness of herniorrhaphy, this disease is an important target
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for LMICs planning surgical capacity improvements. (C) 2014 Surgical
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Associates Ltd. Published by Elsevier Ltd. All rights reserved.'
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affiliation: 'Stewart, BT (Corresponding Author), Univ Washington, Dept Surg, 1959
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NE Pacific St,Suite BB 487,POB 356410, Seattle, WA 98195 USA.
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Stewart, Barclay T., Univ Washington, Dept Surg, Seattle, WA 98195 USA.
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Pathak, John, Kathmandu Med Coll, Kathmandu, Nepal.
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Gupta, Shailvi; Nwomeh, Benedict C.; Kushner, Adam L., Surg OverSeas SOS, New York,
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NY USA.
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Gupta, Shailvi, Univ Calif San Francisco East Bay, Dept Surg, Oakland, CA USA.
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Shrestha, Sunil, Nepal Med Coll, Dept Surg, Kathmandu, Nepal.
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Groen, Reinou S., Johns Hopkins Univ Hosp, Dept Gynecol \& Obstet, Baltimore, MD
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21287 USA.
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Nwomeh, Benedict C., Nationwide Childrens Hosp, Dept Pediat Surg, Columbus, OH USA.
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Kushner, Adam L., Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore,
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MD USA.
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Kushner, Adam L., Columbia Univ, Dept Surg, New York, NY USA.
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McIntyre, Thomas, SUNY Downstate Med Sch, Kings Cty Hosp Ctr, Program Surg \& Publ
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Hlth, Brooklyn, NY USA.'
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author: Stewart, Barclay T. and Pathak, John and Gupta, Shailvi and Shrestha, Sunil
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and Groen, Reinou S. and Nwomeh, Benedict C. and Kushner, Adam L. and McIntyre,
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Thomas
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author-email: stewarb@uw.edu
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author_list:
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- family: Stewart
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given: Barclay T.
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- family: Pathak
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given: John
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- family: Gupta
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given: Shailvi
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- family: Shrestha
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given: Sunil
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- family: Groen
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given: Reinou S.
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- family: Nwomeh
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given: Benedict C.
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- family: Kushner
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given: Adam L.
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- family: McIntyre
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given: Thomas
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da: '2023-09-28'
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doi: 10.1016/j.ijsu.2014.12.003
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eissn: 1743-9159
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files: []
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issn: 1743-9191
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journal: INTERNATIONAL JOURNAL OF SURGERY
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keywords: Hernia; Surgical capacity; Nepal; Low-income; Community assessment
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keywords-plus: 'CATARACT SURGICAL COVERAGE; MIDDLE-INCOME COUNTRIES; INGUINAL-HERNIA;
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SIERRA-LEONE; COST-EFFECTIVENESS; GROIN HERNIA; RISK-FACTORS; SURGERY;
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BARRIERS; EPIDEMIOLOGY'
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language: English
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month: JAN
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number-of-cited-references: '34'
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orcid-numbers: 'Stewart, Barclay/0000-0002-8099-9218
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Kushner, Adam/0000-0002-7797-4837'
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pages: 111-114
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papis_id: c6a219ef55cba23da084e9d398519569
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ref: Stewart2015estimatehernia
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times-cited: '11'
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title: An estimate of hernia prevalence in Nepal from a countrywide community survey
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000348666000021
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usage-count-last-180-days: '0'
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usage-count-since-2013: '5'
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volume: '13'
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web-of-science-categories: Surgery
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year: '2015'
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