ArticlePloS one2019
Treatment-seeking for vaginal fistula in sub-Saharan Africa.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Vaginal foreign body for contraceptive purposes resulting in vesicovaginal fistula in an unmarried nulliparous woman: a case report.International journal of surgery case reports · 2026Article
- Epidemiological profile, clinical characteristics, and surgical outcomes of genital fistula repair in Kinshasa, Democratic Republic of Congo: FisPro DRC Experience.The Pan African medical journal · 2026Article
- Undiagnosed Sacrococcygeal Fistulas: A Case Report.Cureus · 2026Article
- Prevalence of unplanned first pregnancy and socioeconomic factors in Benin: a cross-sectional and analytical study.BMJ public health · 2024Article
- Factors associated with reintegration trajectory following female genital fistula surgery in Uganda.AJOG global reports · 2023Article
- Gynecological Fistulae-Has Anything Changed in the Diagnosis and Treatment over the Last Decade? A Narrative Literature Review.Medicina (Kaunas, Lithuania) · 2023Review
- The social, economic, emotional, and physical experiences of caregivers for women with female genital fistula in Uganda: A qualitative study.Global public health · 2023Article
- Understanding Healthcare-Seeking Pathways and Dilemmas Among Women with Obstetric Fistulas in Ethiopia: A Qualitative Inquiry.International journal of women's health · 2023Article
- Measuring barriers to fistula care: investigating composite measures for targeted fistula programming in Nigeria and Uganda.BMC women's health · 2021Article
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2 authors.
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Abstract
backgroundThere 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.
methodsThe 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).
resultsAmong 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.
conclusionTreatment-seeking for fistula remains low and it should be improved through addressing health-system, psycho-social, economic and awareness barriers.
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