Determinants of prostate specific antigen screening test uptake in an urban community in North-Central Nigeria

Background: Despite the increasing incidence of Prostate cancer, there has not been any focused screening policy or strategy in sub-Saharan Africa including Nigeria.Objectives: To assess the level of awareness and uptake of PSA screening test and their determinants in a Nigerian community.Methods: A cross-sectional population survey of men with no prior history of prostate cancer was carried out. Logistic re- gression analysis was used to determine the effect of identified variables in predicting awareness and uptake of prostate cancer screening.Results: Mean age was 51.5±9.8 years; a few men (31, 16.9%) had ever heard of the screening test and most got the information from health centers. A low proportion (8, 4.4%) had taken the screening test. Men with incomes above poverty line (OR = 11.7 2.8–50.1, p = .001) or those with health insurance (OR = 2.7 1.2–6.5, p = .023) were significantly more likely to be aware of the test. Only the men with higher incomes (OR = 25.6 5.8–114.2, p = .0001) were significantly more likely to have taken the test.Conclusion: Higher incomes and health insurance status impact screening awareness but only income status determines if men subsequently proceed to take the PSA screening test.Keywords: Prostate cancer; PSA screening; sub-Saharan Africa; Nigeria

Determinants of prostate specific antigen screening test uptake in an urban community in North-Central Nigeria

Background: Despite the increasing incidence of Prostate cancer, there has not been any focused screening policy or strategy in sub-Saharan Africa including Nigeria. Objectives: To assess the level of awareness and uptake of PSA screening test and their determinants in a Nigerian community. Methods: A cross-sectional population survey of men with no prior history of prostate cancer was carried out. Logistic regression analysis was used to determine the effect of identified variables in predicting awareness and uptake of prostate cancer screening. Results: Mean age was 51.5\ub19.8 years; a few men (31, 16.9%) had ever heard of the screening test and most got the information from health centers. A low proportion (8, 4.4%) had taken the screening test. Men with incomes above poverty line (OR = 11.7 2.8\u201350.1, p = .001) or those with health insurance (OR = 2.7 1.2\u20136.5, p = .023) were significantly more likely to be aware of the test. Only the men with higher incomes (OR = 25.6 5.8\u2013114.2, p = .0001) were significantly more likely to have taken the test. Conclusion: Higher incomes and health insurance status impact screening awareness but only income status determines if men subsequently proceed to take the PSA screening test. DOI: https://dx.doi.org/10.4314/ahs.v19i1.42 Cite as: Bello JO, Buhari T, Mohammed TO, Olanipekun HB, Egbuniwe AM, Fasiku OK, et al. Determinants of prostate specific antigen screening test uptake in an urban community in North-Central Nigeria. Afri Health Sci. 2019;19(1). 1665-1670. https://dx.doi.org/10.4314/ ahs. v19i1.4

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies