Prevalence of obstetric fistula: a population-based study in rural Pakistan

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Prevalence of obstetric fistula : a population-based study in rural Pakistan. / Jokhio, A H; Rizvi, R M; Rizvi, J; MacArthur, C.

In: BJOG: An International Journal of Obstetrics & Gynaecology, Vol. 121, No. 8, 07.2014, p. 1039-46.

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@article{d9bd93d41982462f8878cc8cbc1bfdc9,
title = "Prevalence of obstetric fistula: a population-based study in rural Pakistan",
abstract = "OBJECTIVE: To estimate the prevalence of obstetric fistula, its duration and impact on women's daily life using robust data collection methods in a population-based sample in rural Pakistan.DESIGN: A population-based, cross-sectional study.SETTING: A rural community in Sindh Province, Pakistan.POPULATION: Randomly selected women aged 15 years or older.METHODS: A multistage random sampling strategy was used to recruit the women. Lady Health Workers interviewed women in their own homes using a structured questionnaire to obtain symptom data. Women with symptoms of incontinence were then examined by female gynaecologists in their local health facilities to confirm obstetric fistula.MAIN OUTCOME MEASURE: Obstetric fistula confirmed by gynaecological examination.RESULTS: Among the 5064 women interviewed (96% response rate), 20 women with obstetric fistula were identified, showing a prevalence of 0.39% of all women (95% confidence interval [95% CI] 0.22-0.57%) and 0.45% of parous women (95% CI 0.25-0.65%). Significantly more of the women with obstetric fistula compared with parous women without fistula were primiparae and aged <20 years. Of the women with obstetric fistula, 40% had had this for >5 years and 90% reported a major impact on their lives, yet only four had consulted a doctor, three of whom had failed repairs.CONCLUSIONS: The prevalence of obstetric fistula is high in rural Pakistan. Appropriate provision is needed for fistula repair to reduce the burden of the condition. Alongside this, the improvement of maternity care services is urgently needed to prevent its continued occurrence.",
keywords = "Adolescent, Adult, Cross-Sectional Studies, Female, Gynecological Examination, Humans, Obstetric Labor Complications, Pakistan, Parity, Pregnancy, Prevalence, Quality of Life, Questionnaires, Risk Factors, Rural Population, Vesicovaginal Fistula",
author = "Jokhio, {A H} and Rizvi, {R M} and J Rizvi and C MacArthur",
note = "{\textcopyright} 2014 Royal College of Obstetricians and Gynaecologists.",
year = "2014",
month = jul,
doi = "10.1111/1471-0528.12739",
language = "English",
volume = "121",
pages = "1039--46",
journal = "BJOG: An International Journal of Obstetrics & Gynaecology",
issn = "1470-0328",
publisher = "Wiley",
number = "8",

}

RIS

TY - JOUR

T1 - Prevalence of obstetric fistula

T2 - a population-based study in rural Pakistan

AU - Jokhio, A H

AU - Rizvi, R M

AU - Rizvi, J

AU - MacArthur, C

N1 - © 2014 Royal College of Obstetricians and Gynaecologists.

PY - 2014/7

Y1 - 2014/7

N2 - OBJECTIVE: To estimate the prevalence of obstetric fistula, its duration and impact on women's daily life using robust data collection methods in a population-based sample in rural Pakistan.DESIGN: A population-based, cross-sectional study.SETTING: A rural community in Sindh Province, Pakistan.POPULATION: Randomly selected women aged 15 years or older.METHODS: A multistage random sampling strategy was used to recruit the women. Lady Health Workers interviewed women in their own homes using a structured questionnaire to obtain symptom data. Women with symptoms of incontinence were then examined by female gynaecologists in their local health facilities to confirm obstetric fistula.MAIN OUTCOME MEASURE: Obstetric fistula confirmed by gynaecological examination.RESULTS: Among the 5064 women interviewed (96% response rate), 20 women with obstetric fistula were identified, showing a prevalence of 0.39% of all women (95% confidence interval [95% CI] 0.22-0.57%) and 0.45% of parous women (95% CI 0.25-0.65%). Significantly more of the women with obstetric fistula compared with parous women without fistula were primiparae and aged <20 years. Of the women with obstetric fistula, 40% had had this for >5 years and 90% reported a major impact on their lives, yet only four had consulted a doctor, three of whom had failed repairs.CONCLUSIONS: The prevalence of obstetric fistula is high in rural Pakistan. Appropriate provision is needed for fistula repair to reduce the burden of the condition. Alongside this, the improvement of maternity care services is urgently needed to prevent its continued occurrence.

AB - OBJECTIVE: To estimate the prevalence of obstetric fistula, its duration and impact on women's daily life using robust data collection methods in a population-based sample in rural Pakistan.DESIGN: A population-based, cross-sectional study.SETTING: A rural community in Sindh Province, Pakistan.POPULATION: Randomly selected women aged 15 years or older.METHODS: A multistage random sampling strategy was used to recruit the women. Lady Health Workers interviewed women in their own homes using a structured questionnaire to obtain symptom data. Women with symptoms of incontinence were then examined by female gynaecologists in their local health facilities to confirm obstetric fistula.MAIN OUTCOME MEASURE: Obstetric fistula confirmed by gynaecological examination.RESULTS: Among the 5064 women interviewed (96% response rate), 20 women with obstetric fistula were identified, showing a prevalence of 0.39% of all women (95% confidence interval [95% CI] 0.22-0.57%) and 0.45% of parous women (95% CI 0.25-0.65%). Significantly more of the women with obstetric fistula compared with parous women without fistula were primiparae and aged <20 years. Of the women with obstetric fistula, 40% had had this for >5 years and 90% reported a major impact on their lives, yet only four had consulted a doctor, three of whom had failed repairs.CONCLUSIONS: The prevalence of obstetric fistula is high in rural Pakistan. Appropriate provision is needed for fistula repair to reduce the burden of the condition. Alongside this, the improvement of maternity care services is urgently needed to prevent its continued occurrence.

KW - Adolescent

KW - Adult

KW - Cross-Sectional Studies

KW - Female

KW - Gynecological Examination

KW - Humans

KW - Obstetric Labor Complications

KW - Pakistan

KW - Parity

KW - Pregnancy

KW - Prevalence

KW - Quality of Life

KW - Questionnaires

KW - Risk Factors

KW - Rural Population

KW - Vesicovaginal Fistula

U2 - 10.1111/1471-0528.12739

DO - 10.1111/1471-0528.12739

M3 - Article

C2 - 24684695

VL - 121

SP - 1039

EP - 1046

JO - BJOG: An International Journal of Obstetrics & Gynaecology

JF - BJOG: An International Journal of Obstetrics & Gynaecology

SN - 1470-0328

IS - 8

ER -