AWARENESS OF VESICOVAGINAL FISTULA AMONG HEALTH WORKERS IN SOME HEALTH FACILITIES OF ZAMFARA STATE, NORTHWEST NIGERIA (original) (raw)
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Vesico-vaginal fistula is an abnormal hole between the urinary bladder and the vagina leading to involuntary discharge of urine into the vagina. Vesico-vaginal fistula still remains one of the main morbidities of childbirth in developing world and Ebonyi Local Government Area of Ebonyi State is a typical example. The study was aimed at identifying those predisposing factors to VVF in women of Ebonyi local government area of Ebonyi State. It is a cross-sectional descriptive community based study and a total of 386 women of child bearing age were assessed using interviewer administered questionnaires. The study revealed that 80% (309) of the studied population were aware of VVF. The study also revealed that the predisposing factors to VVF were influenced by one's level of education and employment status as both variables were statistically significant. Level of education and employment status were directly proportional to one's knowledge and inversely proportional to those predisposing factors to the development of VVF. In conclusion, major breakthrough is still needed in order to get the women of Ebonyi Local Government Area of Ebonyi State to actually know about VVF and those predisposing factors for the development of VVF. To decrease those predisposing factors that can lead to VVF; the study suggested advocacy, health education, economic empowerment of women, girl child education and improving the socioeconomic status of women as tools to bringing the desired change.
Trend Analysis of Vesico-vaginal Fistula among Attendee’s in Fistula Centres in Kano State, Nigeria
Journal of Advances in Medicine and Medical Research
A study on the trend analysis of VVF among attendee’s in fistula centers, Kano State, Nigeria was carried out using ten (10) years hospital records. Results showed three peaks in prevalence in year 2010 (73.8%), 2015 (77.2%) and 2017 (59.3%). The highest peak was in the year 2015 while the lowest prevalence occurred in 2014 (46.0%). Overall, there is a decline in prevalence for the ten years studied. It was observed in this study that most of the patients reside in the rural area of the state, where lack of access to appropriate emergency obstetric care and strong hold to traditional practice is obtained. Therefore, there is need to expand the current strategies employed in the fight against VVF to include initiating a men-targeted programme to enlighten and educate men, especially those living in rural areas on the need to allow their women access to medical care during pregnancy to avoid complications that could result to Vesico-vaginal fistula.
Background: Vesico-vaginal fistula is still a persisting scourge in the developing countries with devastating medical and social consequences. These consequences were studied among patients presenting with VVF at a large referral center in Kano, Northern Nigeria. Methods: A total of 120 patients with Vesico-vaginal fistula admitted at the VVF centre of the Murtala Mohammed Specialist Hospital, Kano were investigated using structured questionnaires to determine their medical and social problems. Additional information on clinical features was obtained from patients' case notes. Results: Their ages ranged between 10 and 36 years with a median of 16 years. A majority of the patients 87 (72.5%) were between 10-20 years. Most of the patients 98(81.6%) had their first marriage between the ages of 10 -15 years. Patients were found to suffer from vulval dermatitis, foot drop, amenorrhoea, recurrent urinary tract infections and dysmenorrhoea as main medical problems. Economically they cannot work because they are shunned by the society. They are considered to have brought shame and dishonour to themselves and their families, and where they manage to avoid not being divorced by their husbands they quite often lose any form of support from the husbands. Conclusion: Special counselling and enlightenment programme on VVF, the need to train more traditional birth attendants and the need to improve referral of women likely to have VVF to facilities that offer emergency obstetric services were recommended.
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Background: Vesico-vaginal Fistula (VVF) is defined as an abnormal communicating tract extending between the bladder (vesico-) and the vagina resulting in continuous involuntary discharge of urine into the vaginal vault. Vesico-vaginal fistula is still a persisting scourge in the developing countries, including Sudan in which 5000 new cases of obstetric fistula were estimated to occur every year. The objectives of this work were to study the contributing factors of vesico-vaginal fistula in Sudanese patients. Methods: The design was descriptive, cross-sectional, community-based study. A total of 52 patients with vesicovaginal fistula presented to the Fistula Centre in Khartoum Teaching Hospital from July to August 2008, were investigated using an administrated, semi-structured questionnaire. Results: The study revealed that 44.2% of patients were 18-24 years old, 58.8% were teenagers when married (<18 yrs old). While 75% of the patients were illiterates, 62.8% were married to illiterate husbands. (80.8%) were poor, (40.4%) were from western regions of Sudan. The study showed that labor was responsible for 90.4% of VVF of whom 59.6% were primiparous, 42.6% delivered at home. It was found that 40.4% of the total deliveries were by forceps as long as 27.7% were emergency caesarian sections. (53.2%) of the deliveries were attended by traditional birth attendants and 55.3% of cases stayed in labor for more than 24 hours, as long as 53.2% were not in regular antenatal care. Conclusion: The vesico-vaginal fistula in Sudan resulted mainly from obstructed labor. The victim was mostly a young woman, a primigravida, who was poor, illiterate, not on regular antenatal care & being in labor more than 24 hours. Most deliveries were carried at home, attended by Traditional Birth Attendants in most cases. The deliveries were mostly assisted by forceps, or conducted as emergency caesarian sections. To prevent VVF, the study suggested raising awareness of women at bearing age; improve transportation, besides inclusion of the issue in the curricula of schools and universities.
View related articles Citing articles: 6 View citing articles Gender and Development 70 E arly marriage still poses a problem in most parts of Nigeria, as in many other countries in Africa and beyond. It is practised and justified in the name of tradition, culture, and religion. Especially vulnerable are young girls in rural, poor, and deprived communities. This situation reflects the relatively strong adherence to tradition, and the relative lack of opportunities, affecting women in rural areas. In eastern Nigeria in general, and among the Ibibios in particular, early marriage dates back to the formation of the society itself. In this part of Nigeria, it is not uncommon for girls below the age of 13 to get married, but this is no longer very widespread. The National Baseline Survey of Positive and Harmful Traditional Practices affecting Women and Girls in Nigeria reveals that the aggregate mean age at marriage for female children is 16.7 years. In the northeast , the age is 15.2 years and in the northwest , 14.2 years. This is an indicator of the prevalence of early marriage. 1 The rights of girl children are protected by a legal framework, including national laws and international and regional conventions which Nigeria has ratified. The applicable international conventions and charters are the 1989 Convention on the Rights of the Child (CRC), the 1979 Convention on the Elimination of all Forms of Discrimination against Women (CEDAW), the 1981 African Charter on Human and Peoples' Rights, and the 1990 African Charter on the Rights and Welfare of the Child. 2 Defining the 'child' Under Nigerian law, the concept of the 'child' is based exclusively on calendar age (Effah 1996). In the Children and Young Persons Law of the States of the Federation, a Early marriage in eastern Nigeria and the health consequences of vesicovaginal fistulae (VVF) among young mothers Eno-Obong Akpan This paper deals with the problem of early marriage and childbirth in eastern Nigeria, particularly among the Ibibio ethnic group. I intend this paper to be a tool to help both human-rights activists and policy makers to effect positive change for girl children affected by early marriage. First, the paper examines the challenges posed to early marriage by the Nigerian Constitution, and human rights law. The article then focuses on the health risks involved in early pregnancies and, specifically, the fate of young women who are affected by vesico-vaginal fistulae (VVF). The author visited a VVF Centre in Mbribit Itam, Akwa Ibom State, and shares some of the experiences of the interviewees. The paper concludes with some suggestions for reform to address the interests and needs of women.
Epidemiology of Vesico Vaginal Fistula in Maiduguri
Background: Vesico vaginal fistula commonly affects the poor, less educated, teenage group and those experiencing their first deliveries. Objective: To determine the epidemiological variables r associated with vesico vaginal fistula. Methodology: A total of 80 case records of VVF patients managed over a 10 year period were retrospectively studied. Relevant information pertaining to age, parity, and cause of VVF and outcome of management were retrieved from the case notes. The data was analyzed using SPSS package. Results: VVF Constituted 1.4%, of the total Gynecological admissions and 8.0% of the major Gynecological surgeries performed during the period. The prevalence was highest among the Hausa/Fulani and the Kanuris. Majority (76.2%) were over 20 years, with a peak-age specific prevalence rate of 33.8% at the 20-24 years age group. Teenagers only accounted for 23.8%. Most patients sustained the VVF during their first childbirth (51.3%), by the second delivery 78.8% were involved. All the teenagers had only one delivery, while all the grandmultipara were 40 years and above. Ninety percent of them had no supervised antenatal care and had their deliveries at home under traditional birth attendant (TBAs). In about 90% prolong obstructed labour was the leading cause and most patients belong to the social class IV and V. Seventy five percent had successful repair, while about 50% were either divorced or neglected by their husbands. Conclusion: Vesico-vaginal fistula remains one preventable medical/social calamity, now afflicting not just teenagers and primipara, but predominantly older and parous women. Public health education with the provision of accessible efficient intrapartum care is the cornerstone to eradicating this problem.
Awareness of Obstetric Vesicovaginal Fistula among Pregnant Women in a Rural Hospital
Advances in Reproductive Sciences
Background: Giving birth should be a period of joy, but for more than half a million women, their pregnancy and childbirth end in death while some develop vesicovaginal fistula. Vesicovaginal fistula is an abnormal communication between the bladder and the vagina leading to continuous leakage of urine through the vagina. Little is known about the perception of pregnant women about obstetric fistula and this group of women are those who are at risk of the disease. Our aim therefore was to evaluate the level of awareness of vesicovaginal fistula among pregnant women attending antenatal clinic in a rural hospital. Methodology: This was a cross sectional study conducted at Mile 4 missionary Hospital, Abakaliki, between 1st of May and 1st of July, 2017. Data was collected with the use of questionnaire. Ethical clearance was gotten from the institutions ethical committee. Results: Their mean age was 27 ± 5 years and mean parity was 2 ± 2. Awareness of vesicovaginal fistula was 57.8%. Risk factors identified for vesicovaginal fistula were prolonged obstructed labour, instrumental vaginal delivery, caesarean section and short stature. Only 80 (39.2%) believed vesicovaginal fistula could be treated. Conclusion: Awareness of vesicovaginal fistula in the study population was 57.8%. A significant number of women were not aware that vesicovaginal fistula could be treated.
Vesicovaginal Fistula: A Review of Nigerian Experience
West African Journal of Medicine, 2011
BACKGROUND: Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. OBJECTIVE: To review the causes, complications, and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline), WHO website, Bioline Innternational, African Journal on Line, Google scholar, Yahoo, Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1%-100% of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and pregnancy, which were rampant in northern Nigeria, while unskilled birth attendance and late presentation to the health facilities was common nationwide. Among the significant contributory factors to high rate of unskilled birth attendance were poverty, illiteracy, ignorance, restriction of women's movement, non-permission from husband, and transportation. All but one Nigerian studies revealed that primiparous women were the most vulnerable group. Pregnancy outcome was dismal in most cases related to delivery with still birth rate of 87%-91.7%. Stigmatization, divorce and social exclusion were common complications. Overall fistula repair success rate was between 75% and 92% in a few centres that offer such services. CONCLUSION: Vesicovaginal fistula is prevalent in Nigeria and obstetric factors are mostly implicated. It is a public health issue of concern. WAJM 2010; 29(5): 293-298. RÉSUMÉ CONTEXTE: la fistule vésico-vaginale est une calamité évitables, qui a été une menace séculaire dans les pays en développement. OBJECTIF: Passer en revue les causes, les complications, et le résultat de la fistule vésico-vaginale au Nigeria. MÉTHODES: Les études sur la fistule vésico-vaginales ont été recherchées sur Internet. L'information a été obtenue sur PubMed (Medline), site de l'OMS, Bioline Innternational, Revue Africaine sur la ligne, Google scholar, Yahoo, et Medscape e médecine. RÉSULTATS: De nombreuses femmes nigérianes sont atteintes de la fistule vésico-vaginale. L'incidence de la fistule obstétricale annuelle est estimée à 2,11 pour 1000 naissances. Il est plus répandu dans le nord du Nigeria que le sud du Nigeria. Les fistules obstétricales représentent 84,1% -100% de la fistule vésico-vaginale et prolongée dystocie est toujours la cause la plus fréquente (65,9% -96,5%) dans toutes les séries. D'autres causes fréquentes peuvent inclure une césarienne, le cancer avancé du col utérin, de rupture utérine, et Gishiri coupe. Les facteurs prédisposants ont été identifiés mariages et grossesses précoces, qui sévissaient dans le nord du Nigeria, alors que la fréquentation de naissance non qualifiés et la présentation tardive aux services de santé a été commune à l'échelle nationale. Parmi les facteurs importants contribuant au taux élevé d'accouchements en présence de travailleurs non qualifiés sont la pauvreté, l'analphabétisme, l'ignorance, la restriction du mouvement des femmes, la non-autorisation de son mari, et le transport. Toutes, sauf une étude nigériane a révélé que les femmes primipares ont été le groupe le plus vulnérable. Issue de la grossesse a été lamentable dans la plupart des cas liés à la prestation des taux de natalité encore de 87% -91,7%. La stigmatisation, le divorce et l'exclusion sociale étaient des complications fréquentes. Globalement le taux de réussite a été la fistule entre 75% et 92% dans quelques centres qui offrent de tels services. CONCLUSION: fistule vésico-vaginale est courante au Nigeria et en obstétrique facteurs sont principalement en cause. Il s'agit d'un problème de santé publique de portée. WAJM 2010; 29 (5): 293-298. Mots-clés: la fistule vésico-vaginale, étiologie, facteurs favorisants, la prévention, au Nigeria.
2012
The main purpose of this cross sectional study was to assess the knowledge and attitude of women towards vesico vaginal fistula and determine factors associated to knowledge and attitude towards the occurrence of vesico vaginal fistula. A systematic random sampling was used to select 30 settlements from 321 settlements in Birnin Kebbi Local Government area of Kebbi State, Nigeria. There were a total of 380 women involved in this study. Data were collected by constructed questionnaire and analysed by percentage, mean, standard deviation and chi-square. Data was analysed by using level of significant at 0.05. A focus group discussion was carried out amongst women with and women without VVF to assess their knowledge and attitude towards vesico vaginal fistula and occurrence of VVF. The result showed that the prevalence of VVF was 9.5%. Women had low knowledge regarding vesico vaginal fistula 65.8%: While, they seemed to have moderate attitude towards the disease (60.8%). Chi-square test revealed that knowledge level found to be highly significant (p < 0.001) when compared with the knowledge level, attitude level was not found to be significant with the occurrence of VVF (p = 0.432). The result also indicates that women have less knowledge about preventive measures as compared with the risk factors, signs and symptoms. These indicate that there is inadequate awareness among women regarding vesico vaginal fistula. Therefore, there is need for more awareness programs regarding vesico vaginal fistula and also the need for wider research on community-based study in order to determine the actual level of incidence and prevalence.
2010
BACKGROUND: Vesicovaginal fistula is a preventable calamity, which has been an age-long menace in developing countries. OBJECTIVE: To review the causes, complications, and outcome of vesicovaginal fistula in Nigeria. METHODS: Studies on vesicovaginal fistula were searched on the internet. Information was obtained on Pubmed (medline), WHO website, Bioline Innternational, African Journal on Line, Google scholar, Yahoo, Medscape and e Medicine. RESULTS: Many Nigerian women are living with vesicovaginal fistula. The annual obstetric fistula incidence is estimated at 2.11 per 1000 births. It is more prevalent in northern Nigeria than southern Nigeria. Obstetric fistula accounts for 84.1%- 100% of the vesicovaginal fistula and prolonged obstructed labour is consistently the most common cause (65.9%-96.5%) in all the series. Other common causes include caesarean section, advanced cervical cancer, uterine rupture, and Gishiri cut. The identified predisposing factors were early marriage and ...