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Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea

Received: 9 July 2020     Accepted: 4 August 2020     Published: 7 October 2020
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Abstract

Background: obstetric fistula is a devastating childbirth injury as a result of obstructed labor. It leads to chronic urinary incontinence and, in most cases, significant physical and emotional suffering. Its prevalence is high in Sab-Sahara African and South Asian countries. The objective of this study is to determine the incidence and describe the characteristics of women with obstetric Vesico-vaginal fistula. Methods: A retrospective cross-sectional study was conducted in all obstetric vesico-vaginal fistula patients. Patient identification performed through review of prerecorded logbook and patient card describing each patient admitted to fistula ward over a period of five years from January 1st 2014 to December 31, 2018. Medical records were reviewed to obtain data on socio-demographic and obstetric characteristics, clinical details, and treatment. Statistical analysis was performed using STATA-9. Results: There were 146 women with Vesico-vaginal fistula (VVF) admitted to the fistula hospital over the study period; of which 144 of them were obstetric fistula. During the study period the total number of health facility deliveries in Eritrea was 217,119 giving an estimated rate of obstetric VVF of 0.7/1000 facility deliveries. The median age, parity, and number of live births was 30, 3, and 2, respectively. One quarter (n=37) of the cases being in the age group of 20years or younger. The highest incidence of VVF (38%) was observed in Primiparous. 75% gave birth in a health facility, 54% of deliveries were by caesarean section, and 80% of babies were stillborn. 77% of repairs were successful. Conclusion: The incidence of fistula in Eritrea is relatively low as compared to other sub-Saharan African countries. In this study, age at fistula development was older than usually found, which might be due to poor access to emergency obstetric care (EmOC) that contributed more to this problem.

Published in Science Journal of Public Health (Volume 8, Issue 5)
DOI 10.11648/j.sjph.20200805.13
Page(s) 149-154
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Incidence, Obstetric Fistula, Vesico-vaginal Fistula

References
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[2] Integrated Management of Pregnancy and Childbirth: Obstetric Fistula: Guiding principles for clinical management and programme development. World Health Organization 2006.
[3] Hilton P, Vesico-vaginal fistulas in developing countries. International Journal of Gynecology and Obstetrics 82 (2003) 285-295. Doi: 10.1016/s0020-7292(03)0022-4.
[4] Bimbola et al. Obstructed Labour: The Main Cause of Vesico-Vaginal Fistula – Review of Literature. European Journal of Research in Medical Sciences Vol. 1 No. 1 September 2013.
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[6] Maheu-Giroux et al. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data. BMC Pregnancy and Childbirth BMC series – open, inclusive and trusted 2016, 16: 82. DOI: 10.1186/s12884-016-0871-6.
[7] Adler AJ et al. Estimating the prevalence of obstetric fistula: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2013; 13: 246.
[8] Tunçalp Ö, Tripathi V, Landry E, Stanton K, Ahmed S. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015; 93: 60–2. doi: http://dx.doi.org/10.2471/BLT.14.141473.
[9] Danso K, Martey J, Wall L, Elkins T. The epidemiology of genitourinary fistulae in Kumasi, Ghana, 1977–1992. Int Urogynecol J Pelvic Floor Dysfunct 1996; 7: 117–120. doi: 10.1007/BF01894198.
[10] Muleta M, Rasmussen S, Kiserud T. Obstetric fistula in 14,928 Ethiopian women. Acta Obstet Gynecol Scand. 2010; 89 (7): 945–51.
[11] Stanton C, Holtz SA, Ahmed S. Challenges in measuring obstetric fistula. Int J Gynaecol Obstet. 2007; 99 Suppl 1:S4–9. http://dx.doi.org/10.1016/j.ijgo.2007.06.010 pmid: 17765240}.
[12] Muleta M. Obstetric Fistula in Developing Countries: A Review Article. J Obstet Gynaecol Can 2006; 28 (11): 962–966.
[13] Umeora OUJ, Emma-Echiegu NB (2015) Vesico-Vaginal Fistula in Developing Countries - Time to Turn off The Tap. J Preg Child Health 2:e120. doi: 10.4172.
[14] Hinrichsen, D. Obstetric Fistula: Ending the Silence, Easing the Suffering. INFO Reports, No. 2. Baltimore, Johns Hopkins Bloomberg School of Public Health, The INFO Project, Sept. 2004).
[15] Karen D. Cowgill, Jennifer Bishop, Amanda K. Norgaard, Craig E. Rubens and Michael G. Gravett. Obstetric fistula in low-resource countries: an under-valued and under-studied problem – systematic review of its incidence, prevalence, and association with stillbirth. BMC Pregnancy and Childbirth 201515: 193. DOI: 10.1186/s12884-015-0592-2.
[16] Maheu-Giroux M et al. Prevalence of symptoms of vaginal fistula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data. Lancet Glob Health. 2015; 3 (5): e271–8.
[17] M. Stamatakos, C. Sargedi, T. Stasinou & K. Kontzoglou. Vesicovaginal Fistula: Diagnosis and Management, Indian J Surg (March–April 2014) 76 (2): 131–136 DOI 10.1007/s12262-012-0787-y.
[18] Holme A, Breen M, MacArthur C (2007). Obstetric fistulae: a study of women managed at the Monze Mission Hospital, Zambia. BJOG2007; 114: 1010–1017. DOI: 10.1111/j.1471-0528.2007.01353.x.
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    Dawit Sereke, Habte Hailemelecot, Yirgalem Issak, Dawit Estifanose. (2020). Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea. Science Journal of Public Health, 8(5), 149-154. https://doi.org/10.11648/j.sjph.20200805.13

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    ACS Style

    Dawit Sereke; Habte Hailemelecot; Yirgalem Issak; Dawit Estifanose. Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea. Sci. J. Public Health 2020, 8(5), 149-154. doi: 10.11648/j.sjph.20200805.13

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    AMA Style

    Dawit Sereke, Habte Hailemelecot, Yirgalem Issak, Dawit Estifanose. Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea. Sci J Public Health. 2020;8(5):149-154. doi: 10.11648/j.sjph.20200805.13

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  • @article{10.11648/j.sjph.20200805.13,
      author = {Dawit Sereke and Habte Hailemelecot and Yirgalem Issak and Dawit Estifanose},
      title = {Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea},
      journal = {Science Journal of Public Health},
      volume = {8},
      number = {5},
      pages = {149-154},
      doi = {10.11648/j.sjph.20200805.13},
      url = {https://doi.org/10.11648/j.sjph.20200805.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20200805.13},
      abstract = {Background: obstetric fistula is a devastating childbirth injury as a result of obstructed labor. It leads to chronic urinary incontinence and, in most cases, significant physical and emotional suffering. Its prevalence is high in Sab-Sahara African and South Asian countries. The objective of this study is to determine the incidence and describe the characteristics of women with obstetric Vesico-vaginal fistula. Methods: A retrospective cross-sectional study was conducted in all obstetric vesico-vaginal fistula patients. Patient identification performed through review of prerecorded logbook and patient card describing each patient admitted to fistula ward over a period of five years from January 1st 2014 to December 31, 2018. Medical records were reviewed to obtain data on socio-demographic and obstetric characteristics, clinical details, and treatment. Statistical analysis was performed using STATA-9. Results: There were 146 women with Vesico-vaginal fistula (VVF) admitted to the fistula hospital over the study period; of which 144 of them were obstetric fistula. During the study period the total number of health facility deliveries in Eritrea was 217,119 giving an estimated rate of obstetric VVF of 0.7/1000 facility deliveries. The median age, parity, and number of live births was 30, 3, and 2, respectively. One quarter (n=37) of the cases being in the age group of 20years or younger. The highest incidence of VVF (38%) was observed in Primiparous. 75% gave birth in a health facility, 54% of deliveries were by caesarean section, and 80% of babies were stillborn. 77% of repairs were successful. Conclusion: The incidence of fistula in Eritrea is relatively low as compared to other sub-Saharan African countries. In this study, age at fistula development was older than usually found, which might be due to poor access to emergency obstetric care (EmOC) that contributed more to this problem.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Obstetric Vesico-vaginal Fistulae: A Documentary Review of Women Managed in Mendefera Zonal Referral and National Fistula Hospital, Eritrea
    AU  - Dawit Sereke
    AU  - Habte Hailemelecot
    AU  - Yirgalem Issak
    AU  - Dawit Estifanose
    Y1  - 2020/10/07
    PY  - 2020
    N1  - https://doi.org/10.11648/j.sjph.20200805.13
    DO  - 10.11648/j.sjph.20200805.13
    T2  - Science Journal of Public Health
    JF  - Science Journal of Public Health
    JO  - Science Journal of Public Health
    SP  - 149
    EP  - 154
    PB  - Science Publishing Group
    SN  - 2328-7950
    UR  - https://doi.org/10.11648/j.sjph.20200805.13
    AB  - Background: obstetric fistula is a devastating childbirth injury as a result of obstructed labor. It leads to chronic urinary incontinence and, in most cases, significant physical and emotional suffering. Its prevalence is high in Sab-Sahara African and South Asian countries. The objective of this study is to determine the incidence and describe the characteristics of women with obstetric Vesico-vaginal fistula. Methods: A retrospective cross-sectional study was conducted in all obstetric vesico-vaginal fistula patients. Patient identification performed through review of prerecorded logbook and patient card describing each patient admitted to fistula ward over a period of five years from January 1st 2014 to December 31, 2018. Medical records were reviewed to obtain data on socio-demographic and obstetric characteristics, clinical details, and treatment. Statistical analysis was performed using STATA-9. Results: There were 146 women with Vesico-vaginal fistula (VVF) admitted to the fistula hospital over the study period; of which 144 of them were obstetric fistula. During the study period the total number of health facility deliveries in Eritrea was 217,119 giving an estimated rate of obstetric VVF of 0.7/1000 facility deliveries. The median age, parity, and number of live births was 30, 3, and 2, respectively. One quarter (n=37) of the cases being in the age group of 20years or younger. The highest incidence of VVF (38%) was observed in Primiparous. 75% gave birth in a health facility, 54% of deliveries were by caesarean section, and 80% of babies were stillborn. 77% of repairs were successful. Conclusion: The incidence of fistula in Eritrea is relatively low as compared to other sub-Saharan African countries. In this study, age at fistula development was older than usually found, which might be due to poor access to emergency obstetric care (EmOC) that contributed more to this problem.
    VL  - 8
    IS  - 5
    ER  - 

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Author Information
  • Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea

  • Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea

  • Department of Obstetrics and Gynecology, Mendefera Zonal Referral and National Fistula Hospital, Mendefera, Eritrea

  • Department of Obstetrics and Gynecology Orotta National Referral Maternity Hospital, Asmara, Eritrea

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