Burden and seasonality of testicular torsion in tropical Africa: Analysis of incident cases in a Nigerian community

Abstract

Introduction: Children, adolescents and young adults in tropical Africa occasionally presents to the emergency department with testicular torsion. However, no estimates of the burden of the condition is available and there is also sparse evidence of a seasonal variation in incidence. Objective: To determine the incidence and seasonality of the condition in a Nigerian community. Subjects and methods: A retrospective review of incident cases of testicular torsion occurring in a typical tropical sub-Saharan African community between January 2011 and December 2016 was performed. Incidence rates were calculated and trend analysis performed to evaluate for seasonality. Results: Twenty-three patients were seen during the study period and the average annual incidence of testicular torsion among ‘at risk’ males (<40 years) was 2.7/100,000. Testicular salvage rate was 81%. Cases occurred 91% higher than average during the cold season (November to January). Trend analysis revealed a significant seasonal difference in the number of cases seen (p = 0.045) and Post Hoc tests (Tukey) further showed that this is attributable to the seasonal difference between the cold season and the warmer early rains period (p = 0.036). Conclusion: The burden of testicular torsion found in the studied tropical sub-Saharan community is comparable to other regions of the world and seasonal variation in incidence does occur with a significant increase in cases during the cold season. Keywords: Testicular torsion, Seasonality, Disease burden, Orchiopexy, Orchiectomy