Prevalence of obstetric fistula and symptomatic pelvic organ prolapse in rural Ethiopia

Abstract

Introduction and objective: Little is known about the extent to which women in low- and middle-income countries suffer with urological and urogynaecological complications of childbirth. This study measured the prevalence of obstetric fistula and symptomatic pelvic organ prolapse (POP) in east and north Ethiopia.

Methods: We randomly selected 23,023 women of reproductive age (15-49 years) from 113 villages in East Harraghe, South Gondar and West Gojjam, Ethiopia. Trained local health workers administered a validated face-to-face survey and a team of researchers verified data by readministering a random selection (5 %) of the survey. All suspected fistulae were followed up to confirm a clinical diagnosis.

Results: Mean age was 29.5 [standard deviation (SD) 8.05] years. Only 22 % of women were knowledgeable about the symptoms of fistula. The prevalence of all obstetric fistulae was 6:10,000 reproductive-aged women [95 % confidence interval (CI) 3-8], of untreated fistula 2:10,000 (95 % CI 0-4) and of symptomatic POP 100:10,000 (95 % CI 86-114).

Conclusion: The prevalence of obstetric fistula in these rural zones of Ethiopia is relatively low and reflects a substantial reduction from previous reports. Significant numbers of women suffer with symptomatic POP, for which surgical and nonsurgical treatments would be beneficial. Obstetric fistula in north and east Ethiopia is relatively low; however, the many women with symptomatic pelvic organ prolapse could benefit from treatment.

Keywords: Fistula prevalence; Global maternal health; Obstetric fistula; Pelvic organ prolapse.