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Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data

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Maheu-Giroux, Mathieu Filippi, Véronique Maulet, Nathalie [UCL] Samadoulougou, Sékou Ouindpanga [UCL] Castro, Marcia C Kirakoya, Fati [UCL]

BACKGROUND: Vaginal fistula (VF) is one of the most severe maternal morbidities with the immediate consequence of chronic urinary and/or fecal incontinence. The epidemiological evidence regarding risk factors for VF is dominated by facility-based studies. Our aim is to estimate the effect size of selected risk factors for VF using population-based survey data. METHODS: We pooled all available Demographic and Health Surveys and Multiple Indicators Cluster Surveys carried out in sub-Saharan Africa that collected information on VF symptoms. Bayesian matched logistic regression models that accounted for the imperfect sensitivity and specificity of self-reports of VF symptoms were used for effect size estimation. RESULTS: Up to 27 surveys were pooled, including responses from 332,889 women. Being able to read decreased the odds of VF by 13% (95% Credible Intervals (CrI): 1% to 23%), while higher odds of VF symptoms were observed for women of short stature (<150 cm) (Odds Ratio (OR) = 1.31; 95% CrI: 1.02-1.68), those that had experienced intimate partner sexual violence (OR = 2.13; 95% CrI: 1.60-2.86), those that reported sexual debut before the age of 14 (OR = 1.41; 95% CrI: 1.16-1.71), and those that reported a first birth before the age of 14 (OR = 1.39; 95% CrI: 1.04-1.82). The effect of post-primary education, female genital mutilation, and having problems obtaining permission to seek health care were not statistically significant. CONCLUSIONS: Increasing literacy, delaying age at first sex/birth, and preventing sexual violence could contribute to the elimination of obstetric fistula. Concomitant improvements in access to quality sexual and reproductive healthcare are, however, required to end fistula in sub-Saharan Africa.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2016
Language Anglais
Journal information "BMC Pregnancy and Childbirth" - Vol. 16, no.1, p. 82 [1-10] (2016)
Peer reviewed yes
Publisher BioMed Central Ltd. ((United Kingdom) London)
e-issn 1471-2393
Publication status Publié
Affiliations UCL - SSS/IRSS - Institut de recherche santé et société
UCL - SSS/IREC/EPID - Pôle d'épidémiologie et biostatistique
Keywords Sexual health ; Vesicovaginal fistula ; Women’s health ; Obstetric fistula ; rectovaginal fistula ; Reproductive health
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Bibliographic reference Maheu-Giroux, Mathieu ; Filippi, Véronique ; Maulet, Nathalie ; Samadoulougou, Sékou Ouindpanga ; Castro, Marcia C ; et. al. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data. In: BMC Pregnancy and Childbirth, Vol. 16, no.1, p. 82 [1-10] (2016)
Permanent URL http://hdl.handle.net/2078.1/176731