ABSTRACT
Background: Enugu State typifies a Third World environment where most deliveries occur outside the hospital setting. In such circumstances; therefore; hospital-based data about congenital defects are unreliable and call for special methods of approach. Objective: To assess the place of school prevalence survey results in estimating the population incidence of anomalies of the male external genitalia.Method: From February 2; 2002 to August 1; 2004 a sample of male students aged 10 years and above seen in randomly selected secondary schools in Enugu State of Southeast Nigeria were guided through a protocol involving; self-administered questionnaires; physical examinations for evidence and types of anomalies present in their external genitalia and personal interviews. The participant schools were selected by stratified random sampling; first by Local Government Area (LGA) and then by school. Consents for the study were obtained from Local Government authorities; Heads of the schools; and Parents' Teachers Associations; (P T A) Executives. Results: Altogether; four urban and thirteen rural schools were studied over the 18 month-period of the investigation and a total of 6226 male students participated. Overall; 416 (6.8) were identified with various types of external genital anomalies; with the prevalence rates observed being within the ranges of population prevalence reported in the literature. The commonest types of anomalies encountered were crypto-orchidism with / or without scrotal hypoplasia 268 (4.30); inguino-(scrotal) hernias 56 (0.90); and hydrocoeles 52 (0.83); in descending order. As many as 183 (44) of those with congenital genital defects were not aware they had them. When compared with urban schools; rural schools were characterized by a higher frequency [8.4 vs. 2.8respectively; x2 = 58.35; P 0.0001] and a lower level of awareness about anomalies of the external male genitalia [P