Article Category:
Research Article

Implementation and Outcomes of a Pilot Collaborative Surgical Hydrocele Training in Côte d’Ivoire

Kevin Montes Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

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Georgina Angoa Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;

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Catherine M. Bjerum Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio;

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Adama Guira Department of Surgery, Hopital Saint Camille, Nanoro, Burkina Faso;

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Olivier K. Kouadio Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;
Université Nangui Abrogoua, Abidjan, Côte d’Ivoire;

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Allassane F. Ouattara Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;
Université Nangui Abrogoua, Abidjan, Côte d’Ivoire;

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Gary J. Weil Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

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Peter U. Fischer Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

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Aboulaye Meite National Neglected Tropical Diseases Control Program, Ministry of Public Health and Hygiene, Abidjan, Côte d’Ivoire

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Benjamin G. Koudou Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;
Université Nangui Abrogoua, Abidjan, Côte d’Ivoire;

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Philip J. Budge Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri;

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DOI:
https://doi.org/10.4269/ajtmh.23-0554
Volume/Issue:
Ahead of Print
Open access
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Lymphatic filariasis (LF) is a neglected tropical disease that can cause hydrocele and its associated stigma, loss of economic productivity, and depression. Hydrocele surgery is an essential part of LF morbidity management but can be difficult for national programs to implement. To improve access to hydrocele surgeries in Côte d’Ivoire, we provided a WHO-certified surgical training for six surgical teams from five health districts in Côte d’Ivoire. We then evaluated the surgical outcomes and assessed the impact of hydrocele surgery on quality of life of hydrocelectomy patients. Preoperative and operative records were reviewed to describe baseline hydrocele characteristics and operative details. Postoperative interviews were conducted 4 to 6 months after surgical correction using a standardized questionnaire. Seventeen men underwent surgery during the training and were available for an interview at the 6-month visit. At the time of 6-month follow-up, 11/17 (64.7%) reported improvement in activities of daily living and reduction in difficulties with work, 8/17 (47.1%) reported an improved economic situation, 15/17 (88.2%) reported improved social interactions, and 15/16 (93.8%) reported improved sex life after surgical correction. Three patients (17.6%) had minor postoperative complications, but none required hospitalization. All 17 patients who were available for an interview were satisfied with their surgery. Surgical hydrocelectomy training in Côte d’Ivoire was well received and provided life-altering health improvements for participating patients across multiple domains of life. Support to scale up surgical capacity for this neglected problem is needed.

Author Notes

Financial support: The surgical training and follow-up survey were supported by a grant from the Bill and Melinda Gates Foundation to the DOLF Project (grant number OPP1201530). P. J. B. was partially supported by National Institute of Allergy and Infectious Diseases career development award K08AI121422.

Disclosure: Surgical training and postoperative care were provided by the PNL-SGF and were not part of any research activity. Collection of postoperative survey data was considered program evaluation not requiring ethics committee approval. Each participant provided written informed consent to participate in the outcomes survey and analysis.

Authors’ addresses: Kevin Montes, Gary F. Weil, Peter U. Fischer, and Philip J. Budge, Infectious Diseases Division, Department of Medicine, Washington University School of Medicine, St. Louis, MO, E-mails: kevinmontes@wustl.edu, gary.j.weil@wustl.edu, pufischer@wustl.edu, and pbudge@wustl.edu. Georgina Angoa, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire, E-mail: georgina.angoa@csrs.ci. Catherine M. Bjerum, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, E-mail: cxb398@case.edu. Adama Guira, Department of Surgery, Hopital Saint Camille, Nanoro, Burkina Faso, E-mail: guira_adama@yahoo.fr. Olivier K. Kouadio, Allassane F. Ouattara, and Benjamin G. Koudou, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire, and Université Nangui Abrogoua, Abidjan, Côte d’Ivoire, E-mails: olivier.kouadio@csrs.ci, alassane.ouattara@csrs.ci, and guibebi.koudou@csrs.ci. Aboulaye Meite, National Neglected Tropical Diseases Control Program, Ministry of Public Health and Hygiene, Abidjan, Côte d’Ivoire, E-mail: aboulaye_meite77@yahoo.fr.

Address correspondence to Philip J. Budge, Washington University in St. Louis, 4444 Forest Park Ave., St. Louis, MO 63108. E-mail: pbudge@wustl.edu
Copyright:
© The author(s) 2023
Received:
17 Aug 2023
|
Accepted:
12 Sep 2023
|
Published Online:
13 Nov 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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