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Community-based screening for obstetric fistula in Nigeria: a novel approach

BACKGROUND: Obstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula...

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Autores principales: Tunçalp, Özge, Isah, Adamu, Landry, Evelyn, Stanton, Cynthia K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905156/
https://www.ncbi.nlm.nih.gov/pubmed/24456506
http://dx.doi.org/10.1186/1471-2393-14-44
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author Tunçalp, Özge
Isah, Adamu
Landry, Evelyn
Stanton, Cynthia K
author_facet Tunçalp, Özge
Isah, Adamu
Landry, Evelyn
Stanton, Cynthia K
author_sort Tunçalp, Özge
collection PubMed
description BACKGROUND: Obstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula cases. Our study aims to quantify the backlog of obstetric fistula cases within two states via community-based screenings and to assess the questions in the Demographic Health Survey (DHS) fistula module. METHODS: The screening sites, all lower level health facilities, were selected based on their geographic coverage, prior relationships with the communities and availability of fistula surgery facilities in the state. This cross-sectional study included women who presented for fistula screenings at study facilities based on their perceived fistula-like symptoms. Research assistants administered the pre-screening questionnaire. Nurse-midwives then conducted a medical exam. Univariate and bivariate analyses are presented. RESULTS: A total of 268 women attended the screenings. Based on the pre-screening interview, the backlog of fistula cases reported was 75 (28% of women screened). The backlog identified after the medical exam was 26 fistula cases (29.5% of women screened) in Kebbi State sites and 12 cases in Cross River State sites (6.7%). Verification assessment showed that the DHS questionnaire had 92% sensitivity, 83% specificity with 47% positive predictive value and 98% negative predictive value for identifying women afflicted by fistula among women who came for the screenings. CONCLUSIONS: This methodology, involving effective, locally appropriate messaging and community outreach followed up with medical examination by nurse-midwives at lower level facilities, is challenging, but represents a promising approach to identify the backlog of women needing surgery and to link them with surgical facilities.
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spelling pubmed-39051562014-01-30 Community-based screening for obstetric fistula in Nigeria: a novel approach Tunçalp, Özge Isah, Adamu Landry, Evelyn Stanton, Cynthia K BMC Pregnancy Childbirth Research Article BACKGROUND: Obstetric fistula continues to have devastating effects on the physical, social, and economic lives of thousands of women in many low-resource settings. Governments require credible estimates of the backlog of existing cases requiring care to effectively plan for the treatment of fistula cases. Our study aims to quantify the backlog of obstetric fistula cases within two states via community-based screenings and to assess the questions in the Demographic Health Survey (DHS) fistula module. METHODS: The screening sites, all lower level health facilities, were selected based on their geographic coverage, prior relationships with the communities and availability of fistula surgery facilities in the state. This cross-sectional study included women who presented for fistula screenings at study facilities based on their perceived fistula-like symptoms. Research assistants administered the pre-screening questionnaire. Nurse-midwives then conducted a medical exam. Univariate and bivariate analyses are presented. RESULTS: A total of 268 women attended the screenings. Based on the pre-screening interview, the backlog of fistula cases reported was 75 (28% of women screened). The backlog identified after the medical exam was 26 fistula cases (29.5% of women screened) in Kebbi State sites and 12 cases in Cross River State sites (6.7%). Verification assessment showed that the DHS questionnaire had 92% sensitivity, 83% specificity with 47% positive predictive value and 98% negative predictive value for identifying women afflicted by fistula among women who came for the screenings. CONCLUSIONS: This methodology, involving effective, locally appropriate messaging and community outreach followed up with medical examination by nurse-midwives at lower level facilities, is challenging, but represents a promising approach to identify the backlog of women needing surgery and to link them with surgical facilities. BioMed Central 2014-01-24 /pmc/articles/PMC3905156/ /pubmed/24456506 http://dx.doi.org/10.1186/1471-2393-14-44 Text en Copyright © 2014 Tunçalp et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tunçalp, Özge
Isah, Adamu
Landry, Evelyn
Stanton, Cynthia K
Community-based screening for obstetric fistula in Nigeria: a novel approach
title Community-based screening for obstetric fistula in Nigeria: a novel approach
title_full Community-based screening for obstetric fistula in Nigeria: a novel approach
title_fullStr Community-based screening for obstetric fistula in Nigeria: a novel approach
title_full_unstemmed Community-based screening for obstetric fistula in Nigeria: a novel approach
title_short Community-based screening for obstetric fistula in Nigeria: a novel approach
title_sort community-based screening for obstetric fistula in nigeria: a novel approach
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905156/
https://www.ncbi.nlm.nih.gov/pubmed/24456506
http://dx.doi.org/10.1186/1471-2393-14-44
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