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

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International Urogynecology Journal Aims and scope Submit manuscript

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.

Brief summary

Obstetric fistula in north and east Ethiopia is relatively low; however, the many women with symptomatic pelvic organ prolapse could benefit from treatment.

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Acknowledgments

We are very grateful to Johnson & Johnson for providing funding for this project and to Hamlin Fistula Ethiopia for supporting the use of valuable resources. Many people contributed to the research, including health extension workers who collected data; health center staff who assisted in data verification; Hirut Kinfu, Mebkyou Tadesse, and Mohammed Amin who trained data collectors; and volunteers Greg Morris, Clara Cantalapiedra, and Jacinta Evans who entered data; and Harriet Andrews, Camilla Ducker, and Ellen Pieterse who assisted with data verification and training of data collectors. Last but not least, we are grateful to the women who kindly allowed us into their homes and their generosity in giving us the time to ask personal questions.

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Authors and Affiliations

  1. Hamlin Fistula Ethiopia, Hamlin Fistula Hospital, PO Box 3609, Addis Ababa, Ethiopia

    Karen Ballard, Fekade Ayenachew, Jeremy Wright & Habtamu Atnafu

Authors
  1. Karen Ballard
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  2. Fekade Ayenachew
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  3. Jeremy Wright
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  4. Habtamu Atnafu
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Corresponding author

Correspondence to Karen Ballard.

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Funding

The project was supported by resources from Hamlin Fistula Ethiopia and external funding from Johnson & Johnson. The funders had no role in study design, data collection and analysis, decision to publish, or manuscript preparation.

Conflicts of interest

None.

Details of Ethical Approval

The study was granted ethical approval from the Oromia Health Bureau and the Amhara Health Bureau. Permission to undertake the study was also granted by the heads of each district and Hamlin Fistula Ethiopia.

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Ballard, K., Ayenachew, F., Wright, J. et al. Prevalence of obstetric fistula and symptomatic pelvic organ prolapse in rural Ethiopia. Int Urogynecol J 27, 1063–1067 (2016). https://doi.org/10.1007/s00192-015-2933-0

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  • DOI: https://doi.org/10.1007/s00192-015-2933-0

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