Benign anorectal conditions in a rural referral Sudanese hospital: a four-year retrospective review of patients' characteristics in a low-resource setting.

backgroundBenign anorectal surgical conditions represent a spectrum of diseases, including haemorrhoids, anal fissures, non-neoplastic polyps and perianal abscesses with or without inflammatory bowel diseases. They are very common yet underreported in rural and secondary healthcare settings. Limited epidemiological data exist on the prevalence, risk factors, and management trends of these conditions in Sudan. This study aims to reflect and analyse the demographic distribution, clinical diagnoses, and their associations at a Sudanese Secondary Referral Hospital.

methodsA retrospective descriptive study was conducted at Rufaa Teaching Hospital, Al-Jazeera State, Sudan, reviewing medical records from January 2018 to December 2021. All patients diagnosed with benign anorectal conditions were included, while incomplete records, those with other unrelated diagnoses not involving anorectal pathology, and trauma-related anorectal injuries were excluded. We applied descriptive and inferential statistics (Chi-square and Monte Carlo Simulation) to identify associations between demographic factors and specific anorectal diagnoses (p-values < 0.05 were considered significant).

resultsDuring the study period, 1,183 surgical admissions were included, of which 287 (24.3%) met the inclusion criteria for anorectal diagnoses, with a female predominance (72%). Haemorrhoids were the most common benign condition (46%), followed by anal fissures (28.2%), perianal abscesses (18%) and rectal polyps (7.7%). Homemakers and unemployed individuals had higher rates of haemorrhoids and fissures, reaching 65%. Skilled and non-skilled workers experienced more perianal abscesses. Younger patients were more likely to have anal fissures and abscesses. On the other hand, haemorrhoids were more common in older adults, specifically those aged 41 to 60 years and older. Age was a key predictor of rectal polyps, perianal abscesses, and anal fissures.

conclusionsAnorectal conditions cause significant issues in rural areas of Sudan. Gender, occupation, and age all play a role in these differences. Our findings provide baseline epidemiological data to inform planning for diagnostic and resource-allocation strategies in similar low-resource rural settings. Future multi-centre studies are essential to validate these findings and explore additional factors influencing disease patterns and treatment outcomes.