Barriers to Adenoid and Tonsil Surgeries in Ekiti, Nigeria

Adegbiji, Waheed Atilade and Olajide2, Gabriel Toye and Aremu, Shuaib Kayode and Alabi, Sulyman Biodun (2017) Barriers to Adenoid and Tonsil Surgeries in Ekiti, Nigeria. American Journal of Medicine and Medical Sciences, 7 (12). pp. 385-392.

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Abstract

Different form of barriers prevented or delayed patients from undergoing adenoid and tonsillar surgery in low-income countries. This study aimed at determining the prevalence of patients with barriers, types of barriers, identified affected individuals and possible way out to receive required adenotonsillar surgical care. Materials and Methods: This was a prospective hospital based study of patients scheduled for surgical procedures of adenoidectomy, tonsillectomy or both in the Ear, Nose and Throat department of Ekiti state university teaching hospital, Ado Ekiti, over a period of two years between July 2015 and June 2017. Results: A total of 172 patients were scheduled for adenotonsillectomy out of which 89 patients had surgery done over the study period. This represented 51.7% of patients that had surgery done. Majority (59.6%) with barriers were in the age group (1-10) years. There were 64.0% males and 36.0% females with a male: female ratio of 2:1. Majority (60.7%) of the study population were students/apprentice. Among the participants, 34.8% resided in Ado Ekiti, 55.1% live outside Ado Ekiti and within Ekiti state, while 10.1% were from outside Ekiti state. Major indications for the surgeries were obstructive adenotonsillar hypertrophy in 71.9% patients, recurrent tonsillitis in 19.5% while 4.5% were due to otitis media. About 43.8% patients accepted the surgical option. For one reason or the other 23.6% patients’ differed date for the adenotonsillectomy while 19.1% patients preferred to wait for patients to outgrowth the condition. 13.5% of the patients preferred alternative to surgery. In the findings 43.8% patients had both adenoidectomy and tonsillectomy (adenotonsillectomy) done, 24.7% patients had only adenoidectomy done while 31.5% patients had only tonsillectomy done. No barrier was experienced in 15.7% patients, 58.4% patient’s encountered hospital based barrier, 38.2% encountered patients based barrier, and 48.3% of the studied patients encountered barriers from the hospital staffs. High cost of surgical service and cumbersome preoperative surgical tests were barriers in all (100%) patients. Other major barriers to adenotonsillectomy were fear of bleeding in 94.4%, 88.8% are due to fear of complications and 86.5% were due to fear of surgery itself. Conclusions: Close to half of the patients with adenoid and tonsils disorder did not have the scheduled surgery. They were mainly due to patients based barriers, hospitals based barriers and hospital workers based barriers in these study patients

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