High loss to follow-up following obstetric fistula repair surgery in rural Burundi: is there a way forward?

Bishinga, Aristide; Zachariah, Rony; Hinderaker, Sven Gudmund; Tayler‐Smith, Katie; Griensven, Johan van; Boogaard, Wilma van den; Tamura, Motohiko; Christiaens, B.; Sinabajije, G.

doi:10.5588/pha.13.0001

Cited by 9 publications

(19 citation statements)

References 19 publications

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“…Our loss to follow‐up rate at 3 months (21%) was lower than that reported from a routine programme setting (41%) in Burundi by Bishinga et al . and by Browning et al . at 6 months (39.5%).…”

Section: Discussionmentioning

confidence: 81%

“… and higher than what was reported by Bishinga et al . (67%) in Burundi. Even though rates of closure and continence depend on the severity of the fistula, making comparison of different settings difficult, one explanation could be the fact that our programme built on experience in surgical repair of fistula over time, with closure and continence rates increasing over time, while the one in Burundi was in its first year of implementation.…”

Section: Discussionmentioning

confidence: 97%

“…The rate of loss to follow‐up at 3 months in this setting is low compared to 40% reported by Bishinga et al . from Burundi.…”

Section: Discussionmentioning

confidence: 99%

“…As the government in Guinea is planning to launch a new fistula project, we concur with Bishinga et al . that fistula programmes might benefit from a model of cohort monitoring such as that used routinely with chronic diseases such as tuberculosis, where patients are closely followed up for longer periods with various strategies (phones, home visits, community health workers, etc.) to evaluate programmes success.…”

Section: Discussionmentioning

confidence: 99%

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Good clinical outcomes from a 7‐year holistic programme of fistula repair in Guinea

Délamou

Diallo

Béavogui

et al. 2015

Tropical Med Int Health

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ObjectivesFemale genital fistula remains a public health concern in developing countries. From January 2007 to September 2013, the Fistula Care project, managed by EngenderHealth in partnership with the Ministry of Health and supported by USAID, integrated fistula repair services in the maternity wards of general hospitals in Guinea. The objective of this article was to present and discuss the clinical outcomes of 7 years of work involving 2116 women repaired in three hospitals across the country.MethodsThis was a retrospective cohort study using data abstracted from medical records for fistula repairs conducted from 2007 to 2013. The study data were reviewed during the period April to August 2014.ResultsThe majority of the 2116 women who underwent surgical repair had vesicovaginal fistula (n = 2045, 97%) and 3% had rectovaginal fistula or a combination of both. Overall 1748 (83%) had a closed fistula and were continent of urine immediately after surgery. At discharge, 1795 women (85%) had a closed fistula and 1680 (79%) were dry, meaning they no longer leaked urine and/or faeces. One hundred and fifteen (5%) remained with residual incontinence despite fistula closure. Follow-up at 3 months was completed by 1663 (79%) women of whom 1405 (84.5%) had their fistula closed and 80% were continent. Twenty-one per cent were lost to follow-up.ConclusionRoutine programmatic repair for obstetric fistula in low resources settings can yield good outcomes. However, more efforts are needed to address loss to follow-up, sustain the results and prevent the occurrence and/or recurrence of fistula.ObjectifsLa fistule génitale féminine reste un problème de santé publique dans les pays en développement. De janvier 2007 à septembre 2013, le projet Fistula Care, géré par Engender Health en partenariat avec le Ministère de la Santé et soutenu par l’USAID, a intégré les services de réparation de fistules dans les maternités des hôpitaux généraux en Guinée. L'objectif de cet article est de présenter et de discuter les résultats cliniques de sept années de travail impliquant 2116 femmes traitées dans trois hôpitaux à travers le pays.MéthodesIl s'agit d'une étude de cohorte rétrospective utilisant des données extraites des dossiers médicaux de réparations de fistules menées de 2007 à 2013. Les données de l’étude ont été analysées au cours de la période allant d'avril à août 2014.RésultatsLa majorité des 2116 femmes qui ont subi une réparation chirurgicale avaient une fistule vésico vaginale (n = 2 045, 97%) et 3% avaient une fistule recto vaginale ou une combinaison des deux. Au total, 1748 (83%) femmes ont eu leur fistule refermée et sont devenues continentes d'urine immédiatement après la chirurgie. À la sortie, 1795 femmes (85%) avaient une fistule fermée et 1680 (79%) étaient sèches, c'est à dire qu'elles n'avaient plus de fuite d'urine et/ou de matières fécales. 115 (5%) femmes avaient toujours une incontinence résiduelle malgré la fermeture de la fistule. Le suivi à trois mois a été complété par 1663 (79%) femmes dont 1405 (84,5%) on...

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 97%

“…The rate of loss to follow‐up at 3 months in this setting is low compared to 40% reported by Bishinga et al . from Burundi.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Good clinical outcomes from a 7‐year holistic programme of fistula repair in Guinea

Délamou

Diallo

Béavogui

et al. 2015

Tropical Med Int Health

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“…Dependent variable: Recovery from Fistula Surgery: Status of recovery from Fistula surgery (primary repair) is defined using two indicators, status of Fistula closure and patient's post-repair stress incontinence by using Andrew Browning's method [40][41][42].…”

Section: Study Variablesmentioning

confidence: 99%

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Hailu¹

2018

J Preg Child Health

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Background: Ethiopia is one of the high fistula burdened countries in the world with an annual occurrence of 3,500 new and existence of 37,500 untreated obstetric fistula cases. Studies conducted in this area focus on determinants of obstetric fistula before surgical repair and researches addressing the associated factors are limited.Objective: To estimate time to recovery from a surgical repair of obstetric fistula and its associated factors among patients treated at Mekelle Hamlin Fistula Center. Results: The patients were followed for 6657 person days at risk, the median recovery time was 20 days. The overall recovery rate was 2.5 cases per 100 person days. Multivariable Cox proportional hazard model result showed labor duration of two or more days (AHR=0.73, 95% CI=0.53, 0.99) and post-operative bladder catheterization longer than 14 or more days (AHR=0.45, 95% CI=0.32, 0.62) were factors negatively associated with recovery time from obstetric fistula surgery. Methods Conclusion and recommendations:women who experienced labor of two or more days and post-operative bladder drainage for more than two or more weeks took longer time to recover after the repair. Therefore, Decision makers, Health care professionals, Stakeholders and Researchers should give emphasis on activities that reduce delays' in decision making, delays' in giving urgent intervention and delays' in reaching health institutions that contributes in reducing complications of prolonged labor ultimately obstetric fistula.Harmful traditional practices such as early marriage and home delivery are other potential factors for the development of obstetric fistula [8][9][10]. Globally, nine to 84% of obstetric fistula patients gave birth at home and more than 2 million women are currently living with this problem. Additional 50,000 to 100,000 new cases are estimated to occur each year and majority of which are from Africa and Asia [9][10][11][12][13].Incidence rates of obstetric fistula in countries with high maternal mortality is as high as two to three cases per 1000 women [14]. Estimated incidence and prevalence of untreated obstetric fistula in Ethiopia during the year 2010 was 3,500 and 37,500, respectively [9,15]. Introduction BackgroundObstetric fistula is an injury that occurs during prolonged or obstructed labor causing tissue damage to organs inside the pelvis and resulting in incontinence of urine, feces or both. The dead tissues due to prolonged pressure fall away and a hole will be formed between the vagina and bladder called Vesico-vaginal Fistula (VVF) or between the vagina and rectum called Recto Vaginal Fistula (RVF) [1][2][3].Obstetric fistula is the worst child birth related complication that contributes for 2.5% of the Global daily death of mothers associated with child birth related complications [4].The main causes of obstetric fistula in the developed world are radiation therapy and surgery whereas in developing countries, "the three delays" are responsible, the delay in seeking skilled emergency obstetric care, the del...

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Psychosocial Consequences of Obstetric Fistula: Implications for Social Work Policy and Practice

Arkorful

Anokye²,

Hammond³

et al. 2022

Global Encyclopedia of Public Administration, Public Policy, and Governance

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High loss to follow-up following obstetric fistula repair surgery in rural Burundi: is there a way forward?

Cited by 9 publications

References 19 publications

Good clinical outcomes from a 7‐year holistic programme of fistula repair in Guinea

Good clinical outcomes from a 7‐year holistic programme of fistula repair in Guinea

Predictors of Time to Recovery from a Surgical Repair of Obstetric Fistula at Mekelle Hamlin Fistula Center, Tigray, Ethiopia

Psychosocial Consequences of Obstetric Fistula: Implications for Social Work Policy and Practice

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