Hydrocelectomy: a proxy for hydrocele prevalence in coastal Kenya

To assess the value of hydrocelectomy as an indicator of the prevalence of lymphatic filariasis, the frequency of hydrocelectomy was investigated in f ive hospitals in an area of coastal Kenya where filariasis is endemic. Two of the hospitals studied (Kinango and Msambweni) were in Kwale district, tw o (Kilifi and Malindi) in Kilifi district and one (the Coast Provincial Gen eral Hospital) in Mombasa. Surgical operations performed between January 1991 and August 1993 were tal lied from the main theatre registers. Additionally, admission files for hyd rocelectomy patients were examined prospectively between September 1993 and February 1994, to obtain age profiles. Hydrocelectomies accounted for 27.6 %, 16.6%, 13.6%, 4.3% and 2.0% of the major operations (totalling 6339) rec orded in Kinango, Msambweni, Kilifi, Malindi and Coast Provincial General H ospital, respectively. The proportion of operations involving hydrolectomy was significantly higher in the two hospitals in Kwale district, in the sou thern part of the study area, than in the two hospitals in Kilifi district, in the northern part (23.4%, with 95% confidence intervals of 20.9%-25.9%, v. 10.3%, with 95% confidence intervals of 8.7%-11.9%; P<0.001). The gener ally high frequencies of hydrocelectomy in the study area are evidence of t he heavy social and economic burden imposed by hydrocele-attributable,le mo rbidity and its management. The age distribution pattern of the hydrocelectomy patients paralleled that of the individuals with hydrocele in the surrounding area.