UNCOVERING THE HIDDEN BURDEN: A COMMUNITY-BASED SURVEY OF NEGLECTED SURGICAL CONDITIONS IN PLATEAU STATE, NIGERIA dr.alayande@gmail.com

PW07-16

UNCOVERING THE HIDDEN BURDEN: A COMMUNITY-BASED SURVEY OF NEGLECTED SURGICAL CONDITIONS IN PLATEAU STATE, NIGERIA

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Rwanda

Oral or Poster

We informed surgical planning and supported the prioritization of surgery in North-Central Nigeria by determining epidemiology of untreated surgical disease in Mangu Local Government Area, Plateau State, Nigeria, and identified barriers to accessing surgical care.

105 households were selected using a multi-stage, cluster randomized sample design at district, village, and household levels. A community-based cross-sectional structured survey was validated following focus group augmentation and pilot testing and administered during home visits following a community engagement process. We confirmed results by house-to-house physical examination.

We examined 455 individuals (241 females; 214 males) in 9 villages (1 week to 96 years). Twenty-nine surgically amenable conditions were identified with an incidence of 6,734 per 100,000 population. Neglected injuries (1.5%), hernias (1.5%), cataracts with blindness (0.9%), hydroceles (0.7%), and goiters (0.7%) had the highest incidence, neglected up to 10 years. Hemorrhoids, breast lumps, spinal cord injuries, congenital bladder fistula, corneal ulcers and keloids were also identified. Most (58%;18/31) had previously sought care, mostly at inappropriate levels, and less than a quarter had improved. In 18 patients with surgically amenable problems, delays in seeking care were caused by lack of funds (72%), distance from health facilities (44%), ignorance of availability of care (44%) and demotivation by poor road networks (28%).

There is a high incidence of a wide range of neglected surgical conditions in rural Mangu, Plateau State, Nigeria. Community-based insurance for Universal Health Coverage, public sensitization, rural placement of surgical facilities, and improved transportation can help address this challenge.