Prevalence of Undescended Testis and its Associated Factors among under-fives seen at Reproductive and Child Health Clinic in Ifakara, Tanzania

  • J C Bulemela Tanzania Training Centre for International Health assistant Medical Officer School, Ifakara
  • E N Ngibarwa Tanzania Training Centre for International Health assistant Medical Officer School, Ifakara
  • K Ramaiya Hindu Mandal Hospital, Dar es salaam,
  • C Bizzari Spedale Pediatrico Bambino Gesu, Roma
Keywords: Cryptorchidism/undescended testis, underfives, Reproductive Child Health Clinic, small for gestation age

Abstract

Background: The diagnosis of undescended testis/cryptorchidism is missed and ignored by most clinicians following tendency of not performing genital examination in children unless asked by parents. The male sexual differentiation and development is important for the normal reproductive life span. Similarly, risk of carcinoma of testis will be prevented, if early diagnosis of undescended testis (UDT) is made. To aim of the study was to determine the prevalence of undescended testis, its characteristics and associated risk factors among children underfive.

Methods: This was a hospital-based cross sectional study that was conducted at the Reproductive and Child Health Clinic (RCHC) of the St. Francis Referral Hospital (SFRH) from October 2011 to May 2012. The district hospital is located in Ifakara, southeast Tanzania, a city of 49,528 people. Among the estimated 4500 under-five male children in the district attending the RCHC for routine services, 616 children were physically examined their genitalia after consent from their caretakers.

Results: The prevalence of the undescended testis (UDT) was 2.1% (13/616) with 12 children having unilateral UDT and one child with bilateral UDT. About 85% of families of recruited children own durable assets. A small proportion of children, 6.8% (49/616) were of low birth weight and 2.6% (16/616) were born prematurely. Among mothers who had preeclampsia, only 2.4% (1/41) of the children had UDT and none of eclamptic mothers‟ children had UDT. None of the children with UDT had exhibited evidence of birth asphyxia. In case of mothers who had been smoking or exposed to second hand smoking 5.4% (33/616) and those who have been binge drinking alcohol, 0.6% (4/616) of their children had UDT. Among mothers exposed to herbs during pregnancy only 3.2% (1/31) had UDT. None of the mothers had gestational diabetes or existing diabetes mellitus prior to conception.

Conclusion: The prevalence of UDT in this rural setting has a pattern similar to that observed in previous studies in other areas. Efforts should be done to do genital examination by all clinicians. The associated factors exist but no statistically significant association was found and a long term follow up study is needed.

References

A.A. Okeke and D.N. Osegbe. Prevalence and characteristics of cryptorchidism in a Nigerian district. BJU International (2001), 88, 941±945.

Steven G. Docimo, MD, Richard. I. Silver,MD, William Cromie; The Undescended Testicle: Diagnosis and Management. The American Academy of Family Physicians peer reviewed Journal. 2000 Nov 1; 62(9):2037-2044. 3. E. Martin Ritz ´en (Martin.Ritzen@ki.se), A Bergh, R Bjerknes, et al; Nordic consensus on treatment of undescended testes. European Journal of Endocrinology December 1, 2008 159 S87-S90. 4. Mayr et al (1999; Risk factors for undescended testis in Austria. Journal of Andrology. April 2003 5. Sumfest Joel, Thomas F Kolon, MD, Daniel B Rukstalis, MD, Francisco Talavera, PharmD, PhD et al; Cryptorchidism treatment and diagnosis[cited on Jan 20, 2012].Available from http://emedicine.medscape.com/article/438378-treatment. Accessed on April 2012. 6. Dr. Eric Chung,Brock, G.Canada; Cryptorchidism and its impact on male fertility:a state of art review of current literature. Urological Association Journal. 2011 June; 5(3): 210–214. 7. Allan Hackshaw , Charles Rodeck , and Sadie Boniface; Maternal smoking in pregnancy and birth defects. Human Reproduction Update, Vol.0, No.0 pp. 1–16, 2010 8. Virtanen HE, Tapanainen AE, Kaleva MM, et al; Mild gestational diabetes as a risk factor for congenital cryptorchidism. Journal of Clinical Endocrinology and Metabolism. 2006 Dec; 91(12):4862-5. 9. Ida N. Damgaard, Tina K. Jensen, the Nordic Cryptorchidism Study Group et al; Cryptorchidism and Maternal Alcohol Consumption during Pregnancy: Environmental Health Perspective 115(2):272–277 (2007) 10. Michael E. Jones, Anthony J. Swerdlow, Myfanwy, Griffith et al; prenatal risk factors for cryptorchidism: Paediatric and Perinatal Epidemiology 1998, 12, 383-396. 11. Sayi EN, Mlay SM; Undescended testis in paediatric patients in Muhimbili Medical centre, Dar es salaam. East Africa medical Journal, 1994 Feb; 71(2):135-7. 12. Betram G. Katzung et al; Text of basic and clinical pharmacology: 8th edition.

Jensen MS, Bonde JP, Olsen J; Prenatal alcohol exposure and cryptorchidism. Acta Paediatr. 2007 Nov;

Published
2015-12-12
Section
Original Research