Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa

Abstract Background Samoa is a Pacific Island country that has long been known to have a high burden of lymphatic filariasis. Little has been documented about the burden of disability due to the chronic complications of the disease. We examined the rates of hydrocoele amongst the Samoan male populat...

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Main Authors: Tile A. Ah Leong-Lui, Patricia M. Graves, Take Naseri
Format: Article
Language:English
Published: BMC 2019-11-01
Series:Tropical Medicine and Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s41182-019-0179-0
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author Tile A. Ah Leong-Lui
Patricia M. Graves
Take Naseri
author_facet Tile A. Ah Leong-Lui
Patricia M. Graves
Take Naseri
author_sort Tile A. Ah Leong-Lui
collection DOAJ
description Abstract Background Samoa is a Pacific Island country that has long been known to have a high burden of lymphatic filariasis. Little has been documented about the burden of disability due to the chronic complications of the disease. We examined the rates of hydrocoele amongst the Samoan male population to better understand the situation. Methods Information on numbers of suspected hydrocoele cases in men aged 18 years and older from 2006 to 2013 was sought using ICD-10 codes and/or keywords from three sources: the hospital patient information system plus the surgical clinic and operating theater records in Tupua Tamasese Meaole and Malietoa Tanumafili II hospitals in Samoa. Chart review of suspected hydrocoele cases was used to confirm the diagnosis of hydrocoele amongst suspected cases. The following data items were extracted from patient records where available: date of diagnosis, age, village, hydrocoele characteristics (duration, size, and volume), history and cause of injuries, whether lymphatic filariasis was a differential diagnosis, whether ultrasound scan was used to verify diagnosis, and details of any surgery performed. Population data were obtained from the Samoa Bureau of Statistics. Results There were 535 suspected cases identified from the 3 sources between 2006 and 2013, of which 328 were diagnosed as hydrocoele; charts for 56 suspected cases (10.5%) could not be located. The mean age of men with hydrocoele was 49.2 years. The proportion of men aged ≥ 18 years diagnosed with hydrocoele over the study period was 0.62% (328/52,944). North West Upolu had the highest proportion amongst the four regions of Samoa (p < 0.001). The proportion of men presenting with hydrocoele increased with age (p < 0.001). 14.3% of patients had an injury that could have contributed to the hydrocoele. Only 4.0% of all patient records had lymphatic filariasis recorded as a differential diagnosis. 60.7% of all patients with hydrocoele had some form of surgery, with no difference between regions (p = 0.276). The majority of surgeries were hydrocoelectomies, where the tunica vaginalis is everted. The mean age of patients that had surgery was 48.2 years. It was difficult to estimate hydrocoele size and duration due to non-standardized way of reporting. Conclusions This study used multiple sources to document the number of hydrocoele cases that presented annually to medical facilities in Samoa. This represents a minimum estimate of the burden since some cases may have not presented for treatment. The numbers presenting have fluctuated over the years (2006 to 2013), and improvements in the reporting system are needed. The health system needs to consider ways to address a large number of patients that still require surgery, as well as conducting follow-up of those that did receive surgery. Additionally, clinicians should consider lymphatic filariasis as a differential diagnosis for hydrocoeles.
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spelling doaj.art-f68a5dabfa6a438d8a57d1c5662b8c802022-12-21T18:22:49ZengBMCTropical Medicine and Health1349-41472019-11-014711910.1186/s41182-019-0179-0Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, SamoaTile A. Ah Leong-Lui0Patricia M. Graves1Take Naseri2Ah Leong ClinicJames Cook UniversityMinistry of HealthAbstract Background Samoa is a Pacific Island country that has long been known to have a high burden of lymphatic filariasis. Little has been documented about the burden of disability due to the chronic complications of the disease. We examined the rates of hydrocoele amongst the Samoan male population to better understand the situation. Methods Information on numbers of suspected hydrocoele cases in men aged 18 years and older from 2006 to 2013 was sought using ICD-10 codes and/or keywords from three sources: the hospital patient information system plus the surgical clinic and operating theater records in Tupua Tamasese Meaole and Malietoa Tanumafili II hospitals in Samoa. Chart review of suspected hydrocoele cases was used to confirm the diagnosis of hydrocoele amongst suspected cases. The following data items were extracted from patient records where available: date of diagnosis, age, village, hydrocoele characteristics (duration, size, and volume), history and cause of injuries, whether lymphatic filariasis was a differential diagnosis, whether ultrasound scan was used to verify diagnosis, and details of any surgery performed. Population data were obtained from the Samoa Bureau of Statistics. Results There were 535 suspected cases identified from the 3 sources between 2006 and 2013, of which 328 were diagnosed as hydrocoele; charts for 56 suspected cases (10.5%) could not be located. The mean age of men with hydrocoele was 49.2 years. The proportion of men aged ≥ 18 years diagnosed with hydrocoele over the study period was 0.62% (328/52,944). North West Upolu had the highest proportion amongst the four regions of Samoa (p < 0.001). The proportion of men presenting with hydrocoele increased with age (p < 0.001). 14.3% of patients had an injury that could have contributed to the hydrocoele. Only 4.0% of all patient records had lymphatic filariasis recorded as a differential diagnosis. 60.7% of all patients with hydrocoele had some form of surgery, with no difference between regions (p = 0.276). The majority of surgeries were hydrocoelectomies, where the tunica vaginalis is everted. The mean age of patients that had surgery was 48.2 years. It was difficult to estimate hydrocoele size and duration due to non-standardized way of reporting. Conclusions This study used multiple sources to document the number of hydrocoele cases that presented annually to medical facilities in Samoa. This represents a minimum estimate of the burden since some cases may have not presented for treatment. The numbers presenting have fluctuated over the years (2006 to 2013), and improvements in the reporting system are needed. The health system needs to consider ways to address a large number of patients that still require surgery, as well as conducting follow-up of those that did receive surgery. Additionally, clinicians should consider lymphatic filariasis as a differential diagnosis for hydrocoeles.http://link.springer.com/article/10.1186/s41182-019-0179-0Lymphatic filariasisHydrocoeleSamoaHealth information systemsSurgery
spellingShingle Tile A. Ah Leong-Lui
Patricia M. Graves
Take Naseri
Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
Tropical Medicine and Health
Lymphatic filariasis
Hydrocoele
Samoa
Health information systems
Surgery
title Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
title_full Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
title_fullStr Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
title_full_unstemmed Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
title_short Burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country, Samoa
title_sort burden of hydrocoele assessed from medical and surgical records in a lymphatic filariasis endemic country samoa
topic Lymphatic filariasis
Hydrocoele
Samoa
Health information systems
Surgery
url http://link.springer.com/article/10.1186/s41182-019-0179-0
work_keys_str_mv AT tileaahleonglui burdenofhydrocoeleassessedfrommedicalandsurgicalrecordsinalymphaticfilariasisendemiccountrysamoa
AT patriciamgraves burdenofhydrocoeleassessedfrommedicalandsurgicalrecordsinalymphaticfilariasisendemiccountrysamoa
AT takenaseri burdenofhydrocoeleassessedfrommedicalandsurgicalrecordsinalymphaticfilariasisendemiccountrysamoa