Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data

Maheu‐Giroux, Mathieu; Filippi, Véronique; Samadoulougou, Sékou; Castro, Márcia C.; Maulet, Nathalie; Méda, Nicolas; Kirakoya‐Samadoulougou, Fati

doi:10.1016/s2214-109x(14)70348-1

Cited by 96 publications

(121 citation statements)

References 33 publications

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“…Finally, we only searched for systematic reviews rather than primary studies to assess the frequency of these conditions. We are aware of large‐scale analyses of the frequency of important conditions such as anemia, pregnancy‐related infection, and fistula, which provide robust estimates for these conditions. We chose to focus, however, on systematic reviews that use standardized methods to aggregate existing data.…”

Section: Discussionmentioning

confidence: 99%

The frequency of maternal morbidity: A systematic review of systematic reviews

Gon

Leite

Calvert

et al. 2018

Int J Gynecol Obstet

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BackgroundEstimates of the burden of maternal morbidity are patchy.ObjectiveTo conduct a systematic review of systematic reviews of maternal conditions to: (1) make available the most up‐to‐date frequency estimates; (2) identify which conditions do not have reliable estimates; and (3) scrutinize the quality of the available reviews.Search strategyWe searched Embase, MEDLINE, and CINAHL, combining terms for pregnancy, frequency (e.g. prevalence, incidence), publication type, and specific terms for each of 121 conditions.Selection criteriaWe included peer‐reviewed systematic reviews aiming to estimate the frequency of at least one of the conditions in WHO's list of maternal morbidities, with estimates from at least two countries.Data collection and analysisWe present the frequency estimates with their uncertainty bounds by condition, region, and pregnancy/postpartum period. We also assess and present information on the quality of the systematic reviews.Main resultsOut of 11 930 found, 48 reviews were selected and one more was added. From 49 reviews we extracted 34 direct and 60 indirect frequency estimates covering 35 conditions. No review was available for 71% of the conditions on the WHO list. The extracted estimates show substantial maternal morbidity, spanning the time before and beyond childbirth. There were several gaps in the quality of the reviews. Notably, one‐third of the estimates were based only on facility‐based studies.ConclusionsGood‐quality systematic reviews are needed for several conditions, as a research priority.

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Section: Discussionmentioning

confidence: 99%

The frequency of maternal morbidity: A systematic review of systematic reviews

Gon

Leite

Calvert

et al. 2018

Int J Gynecol Obstet

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“…Obstetric fistula (OF) affects an estimated 2 million women worldwide; in sub‐Saharan Africa, the lifetime prevalence is as high as 3.0 per 1000 women of reproductive age . OF usually results from obstructed labor.…”

Section: Introductionmentioning

confidence: 99%

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Kopp

Tang

Bengtson

et al. 2018

BJOG

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Objective We evaluated residual incontinence, depression, and quality of life among Malawian women who had undergone vesicovaginal fistula (VVF) repair 12 or more months previously. Design Prospective cohort study. Setting Fistula Care Centre in Lilongwe, Malawi. Population Women who had undergone VVF repair in Lilongwe, Malawi at least 12 months prior to enrolment. Methods Self‐report of urinary leakage was used to evaluate for residual urinary incontinence; depression was evaluated with the Patient Health Questionnaire‐9; quality of life was evaluated with the King's Health Questionnaire. Main outcome measures Prevalence and predictors of residual incontinence, quality of life scores, and prevalence of depression and suicidal ideation. Results Fifty‐six women (19.3%) reported residual urinary incontinence. In multivariable analyses, predictors of residual urinary incontinence included: pre‐operative Goh type 3 [adjusted risk ratio (aRR) 2.82; 95% confidence interval (CI) 1.61–5.27) or Goh type 4 1.08–2.78), positive postoperative cough stress test (aRR = 2.42; 95% CI 1.24–4.71) and the positive 1‐hour postoperative pad test (aRR = 2.20; 95% CI 1.08–4.48). Women with Goh types 3 and 4 VVF reported lower quality of life scores. Depressive symptoms were reported in 3.5% of women; all reported residual urinary incontinence. Conclusions While the majority of women reported improved outcomes in the years following surgical VVF repair, those with residual urinary incontinence had a poorer quality of life. Services are needed to identify and treat this at‐risk group. Tweetable abstract Nearly one in five women reported residual urinary incontinence at follow up, 12 or months after vesicovaginal fistula repair.

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“…In Uganda, for example, studies reported a growing number of women with a fistula, a shortage of physicians with the skills to treat fistulas, few and insufficiently equipped operating theatres, and a reliance on visiting doctors to treat the large numbers of women awaiting surgery [7]. A prior meta-analysis reported that more than 110,000 women in Ethiopia presently have a vaginal fistula, but less than 2% of them receive fistula surgery each year [8]. This means it will take at least 55 years to treat the existing patients at the current rate provided no new cases occur [9].…”

Section: Introductionmentioning

confidence: 99%

Relying on Visiting Foreign Doctors for Fistula Repair: The Profile of Women Attending Fistula Repair Surgery in Somalia

Gele

Salad

Jimale

et al. 2017

Obstetrics and Gynecology International

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Obstetric fistula is treatable by surgery, although access is usually limited, particularly in the context of conflict. This study examines the profile of women attending fistula repair surgery in three hospitals in Somalia. A cross-sectional study was conducted in Somalia from August to September 2016. Structured questionnaires were administered to 81 women who registered for fistula repair surgery in the Garowe, Daynile, and Kismayo General Hospitals in Somalia. Findings revealed that 70.4% of the study participants reported obstetric labor as the cause of their fistula, and 29.6% reported iatrogenic causes. Regarding the waiting time for the repair surgery, 45% waited for the surgery for over one year, while the rest received the surgery within a year. The study suggests that training for fistula surgery has to be provided for healthcare professionals in Somalia, fistula centers should be established, and access to these facilities has to be guaranteed for all patients who need these services.

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Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data

Abstract: None.

Cited by 96 publications

References 33 publications

The frequency of maternal morbidity: A systematic review of systematic reviews

The frequency of maternal morbidity: A systematic review of systematic reviews

Continence, quality of life and depression following surgical repair of obstetric vesicovaginal fistula: a cohort study

Relying on Visiting Foreign Doctors for Fistula Repair: The Profile of Women Attending Fistula Repair Surgery in Somalia

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