The pattern of non-obstetric fistula: A Cameroonian experience

Tebeu, Pierre-Marie; Touka, Eric Brice; Mawamba, Yvette Nkene; Tiyou, Calvin; Fomulu, Joseph Nelson; Rochat, Charles-Henry

doi:10.1016/s2305-0500(14)60032-4

Cited by 5 publications

(10 citation statements)

References 12 publications

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“…The finding of majority (69.2%) of the genitourinary fistulas in this study being of obstetric origin is in consonance with the finding in studies conducted in Nigeria [17][18][19] and other sub-Saharan African countries 12,21,22 and it exposes the failure of the health systems in the countries across the continent to deliver accessible, timely and appropriate intrapartum care to pregnant women.…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, high iatrogenic fistula prevalence rates were reported in studies conducted in other sub-Saharan African countries including Uganda (25%), 10 and Cameroon (19.78%). 12 These findings are alarming as they imply that women in Africa face a "doubleedged sword" in the course of performing their normal reproductive function, as those who are lucky enough to escape developing obstetric fistula early in their marriage, have iatrogenic fistula to content with later in life, as the overworked and poorly supervised medical officers serving at the inadequately equipped lower levels of healthcare appear to be more preoccupied with saving their lives in the critical situations in which the women often present at the hospital. It is therefore imperative for the governments of the sub-Saharan African countries to strengthen the health systems in their respective countries and make sufficient resources (including money, materials, and manpower) available for provision of universally accessible, timely and appropriate obstetric care.…”

Section: Discussionmentioning

confidence: 99%

“…Mairo Hassan 1 , Kehinde Joseph Awosan 2 in sub-Saharan Africa including Tanzania, 9 Uganda, 10 Nigeria, 11 and Cameroon, 12 as this could worsen the situation, considering the shortage of trained surgeon and facilities for fistula repair, the very low proportion of cases that are operated yearly, and the huge backlog of patents awaiting fistula repair across the continent.…”

Section: Genitourinary Fistulas Experience In a Tertiary Hospital In mentioning

confidence: 99%

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Genitourinary fistulas experience in a tertiary hospital in North-Western Nigeria

Hassan

Awosan

2018

Asian J Med Sci

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Background: Genitourinary fistulas are devastating, with obstetric fistula being the most common type and a major public health problem in the developing world.Aims and Objectives: This study was designed with an aim to determine the epidemiology of genitourinary fistulas in our centre.Materials and Methods: A 5 year (1st January 2013 to 31st December 2017) retrospective review based on data extracted from the case files of patients managed for gynecological fistulas at the Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, North-Western Nigeria, was conducted. A proforma was used to extract data on the research variables. Data were analyzed using IBM SPSS version 24 computer statistical software package.Results: A total of 52 patients with genitourinary fistulas were managed in the period under review. The mean age of the patients was 28.25 ± 10.0 years, and majority of them (65.4%) were aged less than 30 years. Most of them (94.2%) had no formal education, and were full-time housewives (98.1%). Majority of the fistulas (69.2%) were due to prolonged obstructed labor, and close to a quarter of fistulas (23.1%) were of iatrogenic origin. About a third of patients (32.7%) have had at least a previous fistula repair. Most of them (92.3%) had surgical repair done, and it was successful in 65.4% of cases.Conclusion: Although, the genitourinary fistulas in this study were majorly of obstetric origin, a relatively high proportion of cases were of iatrogenic origin. Government should provide universal access to timely and appropriate obstetric care, and also empower women.Asian Journal of Medical Sciences Vol.9(6) 2018 31-36

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Genitourinary Fistulas Experience In a Tertiary Hospital In mentioning

confidence: 99%

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Genitourinary fistulas experience in a tertiary hospital in North-Western Nigeria

Hassan

Awosan

2018

Asian J Med Sci

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“…Indeed in 2014, we found that infection was responsible for 40 % of RVFs managed in our setting. 13 Our findings were similar to those reported by Kouadjio et al in Ivory Coast where 78.6% of non-obstetrical RVFs were attributed to infection. …”

Section: Prevalencesupporting

confidence: 92%

Pattern of non-obstetric infectious recto-vaginal fistula: a case series and literature review in Cameroon, Central Africa

Tebeu¹,

Ekono

Fouogue

et al. 2016

Int J Reprod Contracept Obstet Gynecol

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Background: Perineal infection is an uncommon cause of non-obstetrical recto-vaginal fistula (RVF) which is associated with HIV infection. Cameroon (Central Africa) is in the fistula belt but infectious RVFs have not yet been deeply studied in the country. We therefore sought to determine the pattern of non-obstetric infectious RVF in Cameroon. Methods: We carried out a cross-sectional and descriptive review of non-obstetric infectious RVFs managed at the Yaoundé University Teaching Hospital between January 1, 2009 and December 31, 2015. All complete files were included. The following data were retrieved: socio-demographics, characteristics of the RVF, management and outcome. Results: Five non-obstetrical and non-traumatic RVFs of which four were observed in HIV-infected patients were included. All those RVFs occurred spontaneously. The following predisposing factors were identified: perineal warts (one case out of five), perineal suppuration (two cases out of five), hemorrhoids (the HIV-negative patient), spinsterhood (all cases), unemployment (all cases). All HIV-patients were under anti-retroviral therapy (ART) with good immunological and clinical responses for three of them. Three of them underwent previous unsuccessful surgical cure. Management included ART, antibiotics and surgery. Surgical approaches were perineotomy alone or with martius' flap, procto-perineotomy or trans-vaginal advancement flap. Outcome was satisfactory for all HIV patients (closure of fistula and fecal continence). Conclusions: Local infection is a rare cause of RVF which was associated with HIV in our series. Combined treatment including antibiotics, HAART and surgery gave good results.

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“…Additionally, in Cameroon, approximately 80,000 women and girls suffer from injuries or disabilities caused by complications during pregnancy and childbirth each year [30]. The major causes of maternal mortality in Cameroon are haemorrhage, malaria, complications from unsafe abortion, hypertension, anaemia and pneumonia [24]. The skewed nature of maternal deaths demonstrates that the majority of maternal deaths could be prevented through timely interventions by skilled healthcare providers, whether during the antenatal, delivery or postpartum period [12,5].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study

Warri

George

2020

Preprint

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Background: Antenatal care serves as a key entry point for a pregnant woman to receive a broad range of services and should be initiated at the onset of pregnancy. The aim of the study was to understand the reasons for the late initiation of antenatal care by pregnant women in Nkwen Baptist Health Centre, Cameroon. Methods: The study applied purposive sampling to recruit eighteen pregnant women and three key informants for data collection through individual interviews. Pregnant women who initiated antenatal care after the first trimester were recruited during antenatal care clinics and were interviewed in a room at the Antenatal Care Unit. Key informants were midwives working at the Antenatal Care Unit. Participation in the study was voluntary. The purpose of the study was explained to participants, and they signed a consent form if they were willing to participate in the research. Data were audio-recorded and analyzed using thematic coding analysis. Results: Pregnant women placed a low value on early antenatal care because they perceived pregnancy to be a normal health condition or to not be a serious issue that required seeking health care. Furthermore, previous positive pregnancy outcomes for which women did not access care made them less motivated to initiate antenatal care early. Participants perceived the booking system to be user-unfriendly and complained of overcrowded conditions, long waiting times and some rude service providers. The cost of services and distance to health facilities that required travel via uncomfortable transport on poor road networks were identified as perceived barriers. The absence of effective community health programmes, perceived lack of support from parents and spouses, fear of bewitchment and stigma due to cultural beliefs about the early initiation of antenatal care were also identified as variables influencing late initiation. Conclusion: Pregnant women lack information on the purpose of early antenatal care. Health facility barriers as well as socio-cultural beliefs have significant influences on the timing of antenatal care initiation. The government of Cameroon should strengthen the health system and implement activities to engage communities in improving care seeking for antenatal care and thereby improving maternal health status of women.

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The pattern of non-obstetric fistula: A Cameroonian experience

Cited by 5 publications

References 12 publications

Genitourinary fistulas experience in a tertiary hospital in North-Western Nigeria

Genitourinary fistulas experience in a tertiary hospital in North-Western Nigeria

Pattern of non-obstetric infectious recto-vaginal fistula: a case series and literature review in Cameroon, Central Africa

Perceptions of pregnant women of reasons for late initiation of antenatal care: A qualitative interview study

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