Leaving no one behind: hernia, a neglected surgical condition identified during hydrocele surgery camps in Tanzania

Programs focused on elimination of lymphatic filariasis include the provision of surgery to address hydrocele, a complication of infection. Corrective surgical interventions are fully funded so that affected men in Tanzania can live normal and productive lives. Active case finding is used to identify candidates for hydrocele surgery. Oftentimes this results in men being identified as needing a hydrocelectomy when they actually have inguinal hernias. Given different funding streams, men with hernias do not have access to funded surgeries and are turned away during hydrocele surgical camps despite a clear need for surgical intervention; this poses an ethical dilemma. Also, hernias can occur in conjunction with hydroceles or be misdiagnosed as hydrocele. When misdiagnosis is identified during surgery, and there are no prior preparations to address both, complications can occur. Support from the private sector to complement NTD programs as a viable solution to providing hernia surgeries during hydrocelectomy camps has been used on a small scale in Tanzania and could be replicated on a larger scale.