Evidence map›Paper›PMID 25500564›Full record

ArticleInternational journal of surgery (London, England)2015

An estimate of hernia prevalence in Nepal from a countrywide community survey.

Barclay T Stewart, John Pathak, Shailvi Gupta, Sunil Shrestha, Reinou S Groen, Benedict C Nwomeh, Adam L Kushner, Thomas McIntyre

Open access · greenAbstract read
In one paragraph

Article in International journal of surgery (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
2.1field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Population-based rates of hernia surgery in Ghana.Hernia : the journal of hernias and abdominal wall surgery · 2020
    Article
  6. Article
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  8. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 8 institutions in 2 countries.

Barclay T StewartDepartment of Surgery, University of Washington, Seattle, WA, USA. Electronic address: stewarb@uw.edu.
John PathakKathmandu Medical College, Kathmandu, Nepal.
Shailvi GuptaSurgeons OverSeas (SOS), New York, NY, USA; Department of Surgery, University of California San Francisco East Bay, Oakland, CA, USA.
Sunil ShresthaDepartment of Surgery, Nepal Medical College, Kathmandu, Nepal.
Reinou S GroenDepartment of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA.
Benedict C NwomehSurgeons OverSeas (SOS), New York, NY, USA; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
Adam L KushnerSurgeons OverSeas (SOS), New York, NY, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Surgery, Columbia University, New York, NY, USA.
Thomas McIntyreProgram for Surgery and Public Health, Kings County Hospital Center, SUNY Downstate Medical School, Brooklyn, NY, USA.
Johns Hopkins Hospital · USJohns Hopkins University · USKathmandu Medical College Teaching Hospital · NPKings County Hospital Center · USNationwide Children's Hospital · USNepal Medical College Teaching Hospital · NPUniversity of California, San Francisco · USUniversity of Washington · US

Funding

Northern/Pacific Universities Global Health Research Training ConsortiumR25TW009345 · FIC · UNIVERSITY OF WASHINGTON · PI KOLARS, JOSEPH C., NERURKAR, VIVEK RAMCHANDRA · 2012 to 2016
$5.9M
FIC NIH HHS R25 TW009345FIC NIH HHS R25TW009345
6 · The paper itself

Abstract

backgroundHerniorrhaphy is one of the most frequently performed general surgical operations worldwide. However, most low- and middle-income countries (LMICs) are unable to provide this essential surgery to the general public, resulting in considerable morbidity and mortality. This study aimed to estimate the prevalence, barriers to care and disability of untreated hernias in Nepal.

methodsNepal is a low-income country in South Asia with rugged terrain, infrastructure deficiencies and a severely under-resourced healthcare system resulting in substantial unmet surgical need. A cluster randomized, cross-sectional household survey was performed using the validated Surgeons OverSeas Assessment of Surgical (SOSAS) tool. Fifteen randomized clusters consisting of 30 households with two randomly selected respondents each were sampled to estimate surgical need. The prevalence of and disability from groin hernias and barriers to herniorrhaphy were assessed.

resultsThe survey sampled 1350 households, totaling 2695 individuals (97% response rate). There were 1434 males (53%) with 1.5% having a mass or swelling in the groin at time of survey (95% CI 1.8-4.0). The age-standardized rate for inguinal hernias in men ranged from 1144 per 100,000 persons between age 5 and 49 years and 2941 per 100,000 persons age≥50 years. Extrapolating nationally, there are nearly 310,000 individuals with groin masses and 66,000 males with soft/reducible groin masses in need of evaluation in Nepal. Twenty-nine respondents were not able to have surgery due to lack of surgical services (31%), fear or mistrust of the surgical system (31%) and inability to afford care (21%). Twenty percent were unable to work as previous or perform self-care due to their hernia.

conclusionsDespite the lower than expected prevalence of inguinal hernias, hundreds of thousands of people in Nepal are currently in need of surgical evaluation. Given that essential surgery is a necessary component in health systems, the prevalence of inguinal hernias and the cost-effectiveness of herniorrhaphy, this disease is an important target for LMICs planning surgical capacity improvements.

Indexed as

Health Services AccessibilityHealth Services Needs and DemandAdolescentAdultChildChild, PreschoolCross-Sectional StudiesFemaleGroinHernia, InguinalHerniorrhaphyHumansMaleMiddle AgedNepalPrevalenceCommunity assessmentHerniaLow-incomeNepalSurgical capacity

Identifiers

PMID25500564
PMCPMC4323996
OpenAlexW2004997184

What OpenQuestion holds

Textmetadata
LicenceTDM
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.