Onchocerciasis and acquired groin hernias in Ecuador.

A prevalence of 4.3% (52) groin hernias were observed in 10 communities in the hyperendemic areas of onchocerciasis in Ecuador. Of the 31 patients in whom herniorrhaphy was performed, 87.1% presented with the acquired type of hernias; 15 (48.4%) with direct inguinal and 12 (38.7%) with femoral hernias, while only 12.9% (4) presented with indirect inguinal or the congenital type of hernias. This is in sharp contrast to the usual preponderance of indirect inguinal hernias reported in surveys of other population groups. Mechanisms for this association are discussed.