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Treatment-seeking for vaginal fistula in sub-Saharan Africa

BACKGROUND: There is dearth of data regarding the treatment-seeking practice of women living with vaginal fistula. The paper describes the health-seeking behaviour of fistula cases in the sub-Saharan Africa (SSA) where the burden of the problem is high. METHODS: The data of 1,317 women who ever expe...

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Autores principales: Gebremedhin, Samson, Asefa, Anteneh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824565/
https://www.ncbi.nlm.nih.gov/pubmed/31675379
http://dx.doi.org/10.1371/journal.pone.0216763
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author Gebremedhin, Samson
Asefa, Anteneh
author_facet Gebremedhin, Samson
Asefa, Anteneh
author_sort Gebremedhin, Samson
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description BACKGROUND: There is dearth of data regarding the treatment-seeking practice of women living with vaginal fistula. The paper describes the health-seeking behaviour of fistula cases in the sub-Saharan Africa (SSA) where the burden of the problem is high. METHODS: The data of 1,317 women who ever experienced fistula-related symptom were extracted from 16 national Demographic and Health Surveys carried out in SSA between 2010 and 2017. The association between treatment-seeking and basic socio-demographic characteristics was analysed via mixed-effects logistic regression and the outputs are provided using adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS: Among all women who had fistula-related symptom, 67.6% encountered the problem soon after delivery, possibly implying obstetric fistula. Fewer identified sexual assault (3.8%) and pelvic surgery (2.7%) as the underlying cause. In 25.8% of the cases clear-cut causes couldn’t be ascertained and, excluding these ambiguous causes, 91.2% of the women possibly had obstetric fistula. Among those who ever had any kind of fistula, 60.3% (95% CI: 56.9–63.6%) sought treatment and 28.5% (95% CI: 25.3–31.6%) underwent fistula-repair surgery. The leading reasons for not seeking treatment were: unaware that it can be repaired (21.4%), don’t know where to get the treatment (17.4%), economic constraints (11.9%), the fistula healed by itself (11.9%) and feeling of embarrassment (7.9%). The regression analysis indicated, teenagers as compared to adults 35 years or older [AOR = 0.31 (95% CI: 0.20–47)]; and women without formal education compared to women with formal education [AOR = 0.69 (95% CI: 0.51–0.93)], had reduced odds of treatment-seeking. In 25.9% of the women who underwent fistula-repair surgery, complete continence after surgery was not achieved. CONCLUSION: Treatment-seeking for fistula remains low and it should be improved through addressing health-system, psycho-social, economic and awareness barriers.
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spelling pubmed-68245652019-11-12 Treatment-seeking for vaginal fistula in sub-Saharan Africa Gebremedhin, Samson Asefa, Anteneh PLoS One Research Article BACKGROUND: There is dearth of data regarding the treatment-seeking practice of women living with vaginal fistula. The paper describes the health-seeking behaviour of fistula cases in the sub-Saharan Africa (SSA) where the burden of the problem is high. METHODS: The data of 1,317 women who ever experienced fistula-related symptom were extracted from 16 national Demographic and Health Surveys carried out in SSA between 2010 and 2017. The association between treatment-seeking and basic socio-demographic characteristics was analysed via mixed-effects logistic regression and the outputs are provided using adjusted odds ratio (AOR) with 95% confidence intervals (CI). RESULTS: Among all women who had fistula-related symptom, 67.6% encountered the problem soon after delivery, possibly implying obstetric fistula. Fewer identified sexual assault (3.8%) and pelvic surgery (2.7%) as the underlying cause. In 25.8% of the cases clear-cut causes couldn’t be ascertained and, excluding these ambiguous causes, 91.2% of the women possibly had obstetric fistula. Among those who ever had any kind of fistula, 60.3% (95% CI: 56.9–63.6%) sought treatment and 28.5% (95% CI: 25.3–31.6%) underwent fistula-repair surgery. The leading reasons for not seeking treatment were: unaware that it can be repaired (21.4%), don’t know where to get the treatment (17.4%), economic constraints (11.9%), the fistula healed by itself (11.9%) and feeling of embarrassment (7.9%). The regression analysis indicated, teenagers as compared to adults 35 years or older [AOR = 0.31 (95% CI: 0.20–47)]; and women without formal education compared to women with formal education [AOR = 0.69 (95% CI: 0.51–0.93)], had reduced odds of treatment-seeking. In 25.9% of the women who underwent fistula-repair surgery, complete continence after surgery was not achieved. CONCLUSION: Treatment-seeking for fistula remains low and it should be improved through addressing health-system, psycho-social, economic and awareness barriers. Public Library of Science 2019-11-01 /pmc/articles/PMC6824565/ /pubmed/31675379 http://dx.doi.org/10.1371/journal.pone.0216763 Text en © 2019 Gebremedhin, Asefa http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Gebremedhin, Samson
Asefa, Anteneh
Treatment-seeking for vaginal fistula in sub-Saharan Africa
title Treatment-seeking for vaginal fistula in sub-Saharan Africa
title_full Treatment-seeking for vaginal fistula in sub-Saharan Africa
title_fullStr Treatment-seeking for vaginal fistula in sub-Saharan Africa
title_full_unstemmed Treatment-seeking for vaginal fistula in sub-Saharan Africa
title_short Treatment-seeking for vaginal fistula in sub-Saharan Africa
title_sort treatment-seeking for vaginal fistula in sub-saharan africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824565/
https://www.ncbi.nlm.nih.gov/pubmed/31675379
http://dx.doi.org/10.1371/journal.pone.0216763
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