Cargando…

Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia

BACKGROUND: Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious problem in the world poorest countries, where most mothers give birth without any medical care. In most cases obstetric fistu...

Descripción completa

Detalles Bibliográficos
Autores principales: Yismaw, Leltework, Alemu, Kassahun, Addis, Abebaw, Alene, Muluneh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323782/
https://www.ncbi.nlm.nih.gov/pubmed/30616532
http://dx.doi.org/10.1186/s12905-018-0700-3
_version_ 1783385836411158528
author Yismaw, Leltework
Alemu, Kassahun
Addis, Abebaw
Alene, Muluneh
author_facet Yismaw, Leltework
Alemu, Kassahun
Addis, Abebaw
Alene, Muluneh
author_sort Yismaw, Leltework
collection PubMed
description BACKGROUND: Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious problem in the world poorest countries, where most mothers give birth without any medical care. In most cases obstetric fistula is preventable and can be treated successfully, if it is carried out by a competent surgeon with a good follow-up of postoperative care. However, there remains to explore more on the duration of obstetric fistula recovery and determinant factors. The aim of this study was to estimate the average recovery time of obstetric fistula and to identify its determinants in Gondar University teaching and referral hospital, northwest Ethiopia. METHOD: A retrospective follow up study was conducted at Gondar University teaching and referral hospital. A total of 612 fistula cases were included in the study and simple random sampling technique was applied to select the study subjects. Kaplan-Meier and log rank test were computed to explore the data. Weibull regression survival model with univariate frailty was done to identify the determinant factors of time to recovery. RESULTS: Of 612 fistula patients, 539(88.07%) were recovered. The Average (median) recovery time was 5.14 (IQR = 3.14, 9.14) weeks. Using Antibiotic (AHR = 1.49, 95% CI = 1.11–2.01), having history of antenatal care (ANC) (AHR = 1.95, 95% CI = 1.39–2.73), being literate (AHR = 2.23, 95% CI = 1.62–3.06), duration of bladder catheterization (AHR = 0.93, CI = 0.90–0.95) and being multiparous (AHR = 1.51, 95% CI = 1.17–1.96) were a significant predictors of the rate of recovery. Also, underweight (AHR = 0.45, 95% CI = 0.30–0.68), overweight (AHR = 0.56, 95% CI = 0.41–0.76), being obese (AHR = 0.41, 95% CI = 0.21–0.80), having extensive fistula (AHR = 0.82, 95% CI = 0.73–0.91), large fistula (AHR = 0.42, 95% CI = 0.23–0.78), medium width (AHR = 0.62, 95% CI = 0.43–0.91) and large width (AHR = 0.42, 95% CI = 0.23–0.78) were statistically significant predictors of the rate of recovery from fistula patients. CONCLUSION: The average recovery time from obstetric fistula patients was 5.14 weeks. Small Length and width of fistula, patients’ educational status (literacy), antibiotic use, history of antenatal care visits, normal BMI, short period catheterization and being multiparous were the significant determinate variables which shorten the recovery time of obstetric fistula.
format Online
Article
Text
id pubmed-6323782
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-63237822019-01-11 Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia Yismaw, Leltework Alemu, Kassahun Addis, Abebaw Alene, Muluneh BMC Womens Health Research Article BACKGROUND: Obstetric fistula is an abnormal connection between the vagina and rectum and/or bladder, which leads to continuous urinary or fecal incontinence. It is a serious problem in the world poorest countries, where most mothers give birth without any medical care. In most cases obstetric fistula is preventable and can be treated successfully, if it is carried out by a competent surgeon with a good follow-up of postoperative care. However, there remains to explore more on the duration of obstetric fistula recovery and determinant factors. The aim of this study was to estimate the average recovery time of obstetric fistula and to identify its determinants in Gondar University teaching and referral hospital, northwest Ethiopia. METHOD: A retrospective follow up study was conducted at Gondar University teaching and referral hospital. A total of 612 fistula cases were included in the study and simple random sampling technique was applied to select the study subjects. Kaplan-Meier and log rank test were computed to explore the data. Weibull regression survival model with univariate frailty was done to identify the determinant factors of time to recovery. RESULTS: Of 612 fistula patients, 539(88.07%) were recovered. The Average (median) recovery time was 5.14 (IQR = 3.14, 9.14) weeks. Using Antibiotic (AHR = 1.49, 95% CI = 1.11–2.01), having history of antenatal care (ANC) (AHR = 1.95, 95% CI = 1.39–2.73), being literate (AHR = 2.23, 95% CI = 1.62–3.06), duration of bladder catheterization (AHR = 0.93, CI = 0.90–0.95) and being multiparous (AHR = 1.51, 95% CI = 1.17–1.96) were a significant predictors of the rate of recovery. Also, underweight (AHR = 0.45, 95% CI = 0.30–0.68), overweight (AHR = 0.56, 95% CI = 0.41–0.76), being obese (AHR = 0.41, 95% CI = 0.21–0.80), having extensive fistula (AHR = 0.82, 95% CI = 0.73–0.91), large fistula (AHR = 0.42, 95% CI = 0.23–0.78), medium width (AHR = 0.62, 95% CI = 0.43–0.91) and large width (AHR = 0.42, 95% CI = 0.23–0.78) were statistically significant predictors of the rate of recovery from fistula patients. CONCLUSION: The average recovery time from obstetric fistula patients was 5.14 weeks. Small Length and width of fistula, patients’ educational status (literacy), antibiotic use, history of antenatal care visits, normal BMI, short period catheterization and being multiparous were the significant determinate variables which shorten the recovery time of obstetric fistula. BioMed Central 2019-01-07 /pmc/articles/PMC6323782/ /pubmed/30616532 http://dx.doi.org/10.1186/s12905-018-0700-3 Text en © The Author(s). 2019 Open AccessThis article is 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, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Yismaw, Leltework
Alemu, Kassahun
Addis, Abebaw
Alene, Muluneh
Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title_full Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title_fullStr Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title_full_unstemmed Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title_short Time to recovery from obstetric fistula and determinants in Gondar university teaching and referral hospital, northwest Ethiopia
title_sort time to recovery from obstetric fistula and determinants in gondar university teaching and referral hospital, northwest ethiopia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323782/
https://www.ncbi.nlm.nih.gov/pubmed/30616532
http://dx.doi.org/10.1186/s12905-018-0700-3
work_keys_str_mv AT yismawleltework timetorecoveryfromobstetricfistulaanddeterminantsingondaruniversityteachingandreferralhospitalnorthwestethiopia
AT alemukassahun timetorecoveryfromobstetricfistulaanddeterminantsingondaruniversityteachingandreferralhospitalnorthwestethiopia
AT addisabebaw timetorecoveryfromobstetricfistulaanddeterminantsingondaruniversityteachingandreferralhospitalnorthwestethiopia
AT alenemuluneh timetorecoveryfromobstetricfistulaanddeterminantsingondaruniversityteachingandreferralhospitalnorthwestethiopia