The incidence of external male genital defects in Enugu State of Nigeria: an estimate based on the prevalence among secondary school students
AbstractBackground: Enugu State typifies a Third World environment where most deliveries occur outside the hospital setting. In such circumstances, therefore, hospital-based data about congenital defects are unreliable and call for special methods of approach.
Objective: To assess the place of school prevalence survey results in estimating the population incidence of anomalies of the male external genitalia.
Method: From February 2, 2002 to August 1, 2004 a sample of male students aged 10 years and above seen in randomly selected secondary schools in Enugu State of Southeast Nigeria were guided through a protocol involving; self-administered questionnaires, physical examinations for evidence and types of anomalies present in their external genitalia and personal interviews. The participant schools were selected by stratified random sampling; first by Local Government Area (LGA) and then by school. Consents for the study were obtained from Local Government authorities, Heads of the schools, and Parents' Teachers Associations, (P T A) Executives.
Results: Altogether, four urban and thirteen rural schools were studied over the 18 month-period of the investigation and a total of 6226 male students participated. Overall, 416 (6.8%) were identified with various types of external genital anomalies, with the prevalence rates observed being within the ranges of population prevalence reported in the literature. The commonest types of anomalies encountered were crypto-orchidism with / or without scrotal hypoplasia 268 (4.30%), inguino-(scrotal) hernias 56 (0.90%), and hydrocoeles 52 (0.83%), in descending order. As many as 183 (44%) of those with congenital genital defects were not aware they had them. When compared with urban schools, rural schools were characterized by a higher frequency [8.4% vs. 2.8% respectively; x2 = 58.35; P < 0.0001] and a lower level of awareness about anomalies of the external male genitalia [P = 0.017, by Wilcoxon's rank sum test]. Awareness level was also related to the subject's source of information [P = 0.0012, by Kruskal-Wallis ANOVA].
Conclusion: School prevalence surveys may provide close approximations of population prevalence with respect to external male genital anomalies. There is, however, a need for further studies in this direction.
Orient Journal of Medicine Vol. 18(1&2) 2006: 43-49