Burden and Epidemiology of Inguinal, Femoral, and Abdominal Hernias in the Middle East and North Africa Region From 1990 to 2023 Publisher Pubmed



Hajizadeh A ; Heidari P ; Sadeghian A ; Dehkordi A K ; Ardestani D K ; Saleh F ; Sefatjoo Z ; Sadegh T ; Mansourian B
Source: Surgery (United States) Published:2026

Abstract

Background: There are limited studies on the burden of hernia in the Middle East and North Africa region. This study aimed to assess the burden of inguinal, femoral, and abdominal hernias by utilizing data from the Global Burden of Disease 2023 study. Methods: We retrieved data from the Global Burden of Disease 2023 database for 21 Middle East and North Africa countries. We extracted incidence, death, disability-adjusted life-year rates, and age-standardized rates across countries, years, genders, and age groups. All these metrics were accompanied by 95% uncertainty intervals. Results: The age-standardized disability-adjusted life-year rate of inguinal, femoral, and abdominal hernias decreased from 29.9 (95% uncertainty interval, 20.6–41.1) per 100,000 in 1990 to 20.1 (95% uncertainty interval, 14.5–26.1) in 2023, representing a 32.7% (95% uncertainty interval, − 50.9, − 10.5) decrease. The age-standardized disability-adjusted life-year rate decreased in all Middle East and North Africa countries between 1990 and 2023, and the only exception was Afghanistan, where the age-standardized disability-adjusted life-year rate increased by 3.1% (95% uncertainty interval, − 18.2, 25.3) from 23.5 (95% uncertainty interval, 15.7–33.3) per 100,000 in 1990 to 24.3 (95% uncertainty interval, 16.8–32.6) per 100,000 in 2023. In both 1990 and 2023, the disability-adjusted life-year rate was highest in the 90–94-year age group (122.2 per 100,000 in 1990 and 74.1 per 100,000 in 2023). Conclusion: From 1990 to 2023, the Middle East and North Africa achieved large declines in age-standardized mortality and disability-adjusted life-year rates with modest reductions in incidence. These trends may reflect changing demographic structure, risk exposures, health-system capacity, and/ or case detection and reporting; however, Global Burden of Disease–based estimates do not allow direct attribution to specific preventive or clinical interventions. © 2026 Elsevier Inc. All rights are reserved.