scholarly journals Obstetric Fistula: a retrospective study of 413 cases in Haut-Katanga Province, Democratic Republic of Congo

2020 ◽  
Author(s):  
Joseph B. Nsambi ◽  
Olivier Mukuku ◽  
Prosper L. Kakudji ◽  
Robert Andrianne ◽  
Jean-Baptiste S.Z. Kakoma
Keyword(s):  
Democratic Republic ◽  
Surgical Repair ◽  
Democratic Republic Of Congo ◽  
Obstetric Fistula ◽  
Vaginal Fistula ◽  
Obstructed Labor ◽  
Severe Condition ◽  
Type Size ◽  
The Mean ◽  
Vesico Vaginal Fistula

Abstract Background: In developing countries, fistulae are generally caused by long obstructed labors. Obstetric fistula (OF) is a severe condition which can have devastating consequences for a woman’s life.This study aims to describe the socio-demographic and delivery characteristics of patients with OF in Haut-Katanga province in the Democratic Republic of Congo.Methods: This is a prospective descriptive study of 413 patients with OF in Haut-Katanga province during the period from September 2009 to December 2018.Results: At fistula occurrence, 53.3% of patients were younger than 20 years (mean age: 21.3 ± 6.7 years) and 65.8% were primiparous. More than half had primary education and 39.7% were illiterate; 70.2% of the patients were separated or divorced. Fistula developed after delivery at home in 239 (57.9%) of 413 women. A total of 393 (95.2%) women developed fistula after vaginal delivery. A total of 387 (93.7%) of the 413 women reported that the fetus did not survive the labor during which fistula developed. 92.3% had a vesico-vaginal fistula and the mean age of fistula was 6.5 years. Surgical repair was successful in 82.9%.Conclusion: Obstructed labor remains the most important cause of OF in Haut-Katanga. It is important to prevent OF arising from obstructive causes. The surgical treatment of OF will depend upon the type, size and location of fistula.

scholarly journals Frequency and management of non-obstetric fistula in the Democratic Republic of Congo: experience from Fistula Care Plus project

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Alexandre Delamou ◽  
Michel Mpunga ◽  
Félicien Banze ◽  
Dolores Nembunzu ◽  
Kenny Raha ◽  
...  
Keyword(s):  
Rural Areas ◽  
Democratic Republic ◽  
Surgical Repair ◽  
Democratic Republic Of Congo ◽  
Obstetric Fistula ◽  
Type I ◽  
Medical Procedure ◽  
Republic Of Congo ◽  
Congenital Origin ◽  
Free Generation

Aims: To describe the frequency and management of non-obstetric fistula (NOF) in Democratic Republic of Congo (DRC). Methods: A retrospective cohort study reviewed patients’ medical records in three fistula repair sites supported by the USAID-funded Fistula Care Plus (FC+) Project, covering 1 January 2015 to 31 December 2017. Study variables included demographic characteristics, fistula etiology as reported by surgeon, fistula type (Waaldijk classification), and treatment outcomes. Results: Of 1984 women treated for female genital fistula between 2015 and 2017 in the three sites, 384 (19%) were considered to be NOF cases. 91% of these women resided in rural areas. 49.3% were married/in relationship at time of treatment compared to 69% before the fistula (p<0.001). Most (n=316; 82.3%) had no previous repair attempts and 96.2% had an intact urethra. Type III (n=247; 64.3%) and type I (n=121; 31.5%) fistulas (Waaldijk classification) were most common. The main causes of NOF were medical procedure (n=305; 79.4%), congenital origin (41; 10.7%) or sexual assault (28; 7.3%). Caesarean section (n=234; 76.7%) and hysterectomy (n=54; 17.7%) were the most common causative procedures. 369 women with NOF received surgical repair (96%), mainly through routine services (n=317; 85.9%). At discharge, 353 women were closed and dry (95.7%) and 11 were closed with residual incontinence (3.0%). Conclusions: NOF, particularly due to iatrogenic causes, was relatively common in DRC. Surgical repair at FC+-supported sites led to good clinical outcomes. However, to achieve a fistula-free generation in DRC, prevention of iatrogenic fistula is needed, requiring improved quality of maternal care.

scholarly journals Vesicovaginal fistula (VVF) - A prospective analysis

2016 ◽  
Vol 10 (2) ◽  
Author(s):  
Farah Yousaf ◽  
Muhammad Muzammal Tahir ◽  
Shahida Sheikh
Keyword(s):  
Vesicovaginal Fistula ◽  
Well Being ◽  
Birth Trauma ◽  
Time Interval ◽  
Prospective Analysis ◽  
Vaginal Fistula ◽  
Obstructed Labor ◽  
The Mean ◽  
Set Up ◽  
Vesico Vaginal Fistula

Vesico vaginal fistula disease is as old as antiquity, VVF has a profound effect on the patient`s emotional well being. The main object of our study was to find out the etiology, success of repair, in our set up. A total of 26 patients were included in our study, with the mean age of 30 years, all were almost illiterate (88.56%), Multiparous (57.69%), with the height more than 151cm (53.84%). The cause of injury noted for birth trauma was, Obstructed labor (42.30%). The time interval for the presentation of the patient for the treatment in 61.54% was 2-10 month. The success rate noted was 92.30%.

scholarly journals Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tilahun Fufa Debela ◽  
Zerihun Asefa Hordofa ◽  
Aster Berhe Aregawi ◽  
Demisew Amenu Sori
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Obstetric Fistula ◽  
Medical Center ◽  
Mean Value ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Jimma University

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.

scholarly journals Surgical repair of vesico-vaginal fistula: the need for an evidence-based approach

2018 ◽  
Vol 30 (2) ◽  
pp. 169-170
Author(s):  
Gin-Den Chen ◽  
Diaa E. E. Rizk ◽  
Holly E. Richter
Keyword(s):  
Surgical Repair ◽  
Evidence Based ◽  
Vaginal Fistula ◽  
Vesico Vaginal Fistula

scholarly journals Surgical Outcome of Hundred Vesico Vaginal Fistula Patients in National Fistula Centre

2019 ◽  
Vol 48 (1) ◽  
pp. 39-43
Author(s):  
Shamima Akhter ◽  
Mst Mahbuba ◽  
Nusrat Ara Yusuf ◽  
Munirunnessa ◽  
Nasrin Rosy
Keyword(s):  
Surgical Outcome ◽  
Obstetric Fistula ◽  
Economic Status ◽  
Cross Sectional Study ◽  
Easy Access ◽  
Vaginal Fistula ◽  
Cross Sectional ◽  
Splitting Technique ◽  
Operative Care ◽  
Vesico Vaginal Fistula

Vesico-vaginal fistula (VVF) is still a major global health problem.This study was performed to detect the surgical outcome of 100 VVF patients in National Fistula Centre. A descriptive cross sectional study was carried out among 100 VVF patients fulfilling the inclusion criteria admitted in the National Fistula Centre under the department of Obstetrics and Gynaecology during the study period of April, 2017 to September, 2017. During the period, 100 patients presented for surgical repair at a mean age of 28.7 years (SD7.1). Majority of them (49%) had a parity of one and 57% were less than 20 years old at the time of their first pregnancy. About 83% of women developed VVF following prolonged obstructed labour. Most of the fistula (95%) repaired through vaginal route by flap splitting technique and 73% repaired at 1st time. Recovery of most of the patient (75%) was uneventful. Inadequate post-operative care (26.9%) was the major causes of unsuccessful repair. Obstetric fistula is one of the tragedies of third world countries and it would be better solved by providing surgical procedure and easy access of all women to competent obstetrical care, irrespective of their social and economic  status during pregnancy and delivery. Bangladesh Med J. 2019 Jan; 48 (1): 39-43

scholarly journals Socio-demographic Characteristics of Vesico-vaginal fistula (VVF) patients attended at a tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 114-117
Author(s):  
Shimul Akter ◽  
Naznin Rashid Shewly ◽  
Kashefa Khatun ◽  
Rokshana Parvin Nupur ◽  
Kamrun Nahar ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Medical College Hospital ◽  
Care Hospital ◽  
Vaginal Fistula ◽  
College Hospital ◽  
Medical College ◽  
The Mean ◽  
Vesico Vaginal Fistula

Background: Vesico-vaginal fistula can occur in different women with varied socio-economic condition. Objectives: The purpose of the present study was to see the socio-demographic characteristics of vesico-vaginal fistula (VVF) patients attended at a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out from July 2013 to December 2013 for a period of 6 months in the National Fistula Centre in the Department of Obstetrics & Gynaecology at Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh. All patients who underwent surgical repair for iatrogenic VVF in National Fistula Centre of the department of Obstetrics and Gynaecology of Dhaka Medical College Hospital were included in this study. Patients who got themselves admitted to Obstetrics & Gynaecology department of DMCH with the complaints of fistula. The entire selected patients were interviewed for detailed socio-demographic characteristics. Result: A total number of 51 cases of VVF were recruited for this study. The mean age was 46.02 (±SD 6.104) years. Most of the respondents were illiterate (55.0%) and one-third patients had primary level education. The number of highly educated patients was scarce (12.0%). It was evident that average age at marriage of the patients was 15.8(±4.74) years. Some females were forced to accept marriage at the age of 10 years. The mean interval between initiation of menstruation and the marriage was only 4.72 years. Mothers were on an average 17.48 years old at the time of first delivery. Conclusion: In conclusion middle age illiterate women are most commonly suffering from VVF. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 114-117

Human Breast Milk Assessed by the Deuterium Dose Mother Technique with Less Than 30 g Deuterium Using the Agilent 4500S for Fourier Transform Infrared Spectroscopy: A Pilot Study in the Democratic Republic of Congo

2020 ◽  
Author(s):  
Christine Chimanuka Murhima’Alika ◽  
Ghislain Maheshe Balemba ◽  
Daniella Bugugu Mapendo ◽  
Aminata Kapapa ◽  
Grace Munthali ◽  
...  
Keyword(s):  
Fourier Transform ◽  
Breast Milk ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Human Breast Milk ◽  
Human Breast ◽  
Lactating Mothers ◽  
Milk Output ◽  
The Mean ◽  
Different Doses

Abstract Background: Good breastfeeding practice is essential in preventing malnutrition in children. The deuterium method is the best technique for assessing human breast milk output. We investigated whether deuterium doses < 30 g can be used to assess human breast milk using saliva and the new Agilent 4500S for Fourier transform infrared spectroscopy (FTIR). Methods: In a cross-sectional study, the breastmilk output of lactating mothers was evaluated using four different doses of deuterium in the Miti-Murhesa Health Zone (Democratic Republic of Congo). Lactating mothers of infants aged 3-23 months were recruited and assigned to a dosage group. Weight, height, and mid-upper arm circumference were measured and the body mass index calculated as weight/height2. Body composition (fat mass, free fat mass, total body water, and breastmilk output) was assessed using standard deuterium dilution methods. One-way ANOVA was used to compare the means in different groups and the chi² test to compare proportions. Results: Seventy-five lactating mothers were included in the study: 19 received 6 g, 20 received 10 g, 18 received 15 g, and 18 received 20 g deuterium. The mean ± standard deviation infant age was 10.6 ± 5.2, 11.1 ± 4.4, 10.9 ± 4.4, and 11.0 ± 3.9 months, respectively (p=0.076). We found no difference in the age and anthropometric parameters of the lactating mothers in the different groups. The mean ± standard deviation breast milk output rate was 796.6 ± 292.4, 260.8± 23.2, 749.8 ± 244.2, and 733.6 ± 207.1 g/d in the 6 g, 10 g, 15 g, and 20 g groups, respectively (p=0.883). Conclusions: The different doses of deuterium administered to lactating mothers resulted in similar breast milk output values. Thus, it is possible to evaluate human breast milk with deuterium doses <30 g when using the Agilent 4500S.

Surgical Repair of Orofacial Clefts in North Kivu Province of Eastern Democratic Republic of Congo (DRC)

2020 ◽  
Vol 57 (11) ◽  
pp. 1314-1319
Author(s):  
Luc Malemo Kalisya ◽  
Jacques Fadhili Bake ◽  
Bake Elisee ◽  
Kavira Nyavandu ◽  
Robert Perry ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Democratic Republic ◽  
Cleft Lip And Palate ◽  
Surgical Repair ◽  
Democratic Republic Of Congo ◽  
Orofacial Clefts ◽  
Republic Of Congo ◽  
General Surgeons ◽  
North Kivu

Background: There is a high prevalence of orofacial clefts in low- and middle-income countries with significant unmet need, despite having 50% of the population younger than 18 years in countries such as the Democratic Republic of Congo (DRC). The purpose of this article is to report on the experience of general surgeons with orofacial clefts at a single institution. Methods: This is a retrospective study of patients treated for cleft lip/palate in the province of North Kivu, DRC between 2008 and 2017. Results: A total of 1112 procedures (122/year) were performed. All procedures were performed by general surgeons following training by an international nongovernmental aid organization. A total of 59.2% of patients were male and the median age was 3.4 years (interquartile range: 0.7-13 years). Average distance from surgical center to patient location was 242.6 km (range: 2-1375 km) with outreach performed for distances >200 kms. A majority (82.1%) of patients received general anesthesia (GA) with significant differences in use of GA, age, weight, and length of stay by major orofacial cleft category. Of the 1112 patients, 86.1% were reported to have cleft lip alone, 10.5% had cleft lip and palate, and 3.4% cleft palate alone. Despite this, only 5.3% of patients underwent surgical repair of cleft palate. Conclusions: Multiple factors including malnutrition, risk of bleeding, procedural complexity, and cosmetic results may contribute to the distribution of procedures performed where most cleft palates are not treated. Based on previously published estimates, unmet needs and social burden of cleft lip and palate are high in the DRC.

scholarly journals Living with Vesico-Vaginal Fistula at Jimma University Medical Centre: A Phenomenological Study

2019 ◽  
Vol 5 (5) ◽  
pp. 342
Author(s):  
Yasmin Mohammed Ali
Keyword(s):  
Coping Strategies ◽  
Social Life ◽  
Phenomenological Study ◽  
Medical Condition ◽  
Obstetric Fistula ◽  
Medical Center ◽  
Sampling Technique ◽  
Vaginal Fistula ◽  
Jimma University ◽  
Vesico Vaginal Fistula

Obstetric fistula leaves women with few opportunities to earn a living and worsens their poverty. The death of the baby, inabil­ity to carry a child, and the stigma that accompanies fistula results in significant emotional & psychosocial damage. Vesico-vaginal fistula (VVF) is a medical condition that involves an abnormal opening between the bladder and the vagina, leading to uncontrolled leakage of urine which is resulted mostly from an unattended prolonged labor. Semi-structured in-depth interview was used to explore the lived in experience of eight women with obstetric fistula who were admitted in Jimma University Medical Center selected by purposive sampling technique. The data were analyzed using thematic analysis. Seven themes illustrating the lived in experiences of women with Vesico-vaginal fistula were emerged. These were awareness of altered identity, depression, anxiety, marital problems, disrupted social life, economic problems and coping strategy. Problem focused coping strategies mentioned were having family support, orientating to reality, financial independence and religiousness. Emotion focused coping strategies were also noted, such as, isolation, suicidal thoughts and anger.  Altered psychological, physical, social and economic functioning were some of the disruption in the life of women with VVF observed. Promoting their positive coping strategies, providing physical and psychological support is crucial to reverse debilitating effects of women with VVF.

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