Characteristics of Patients with Obstetric Fistula in a Fistula Centre, Zamfara State, Northern Nigeria

Abstract

Introduction: Obstetric fistula is a highly stigmatized medico-social problem affecting mainly women of reproductive age group. It is commonly due to prolonged obstructed labour leading to necrosis of the urinary bladder and/ or rectum and subsequently to uncontrolled leakage of urine and or/ stool, disability and occasionally death . About two million women live with obstetrics fistula worldwide with 400,000 to 800,000 in Nigeria. We conducted this study to describe the socio-demographic characteristics of patients with obstetric fistula, and determine the causes and types of obstetric fistula seen in Zamfara State, northern Nigeria

Methodology: This was a cross-sectional study. A total of 210 cases were enrolled and administered semistructured questionnaire to obtained data on socio-demographic characteristics and obstetric history. We performed speculum examination screening procedure to ascertain the type of fistula. We analyzed data using SPSS software and Microsoft office Excel 2007.

Results: The median age at marriage and occurrence of fistula were 14years and 17years (IQR; 15.5-20.3) respectively. Of 210 cases, 18 (8.6%) had at least primary education and 178 (84.8%) were rural dwellers. Only 8 (3.8%) had antenatal care services (ANC), 144 (68.6%) laboured for more than 24hours and 145 (69.1%) delivered at home. The main reasons for home delivery were husband/family did not allow hospital delivery (44.8%), not customary (22.7%), no transport (21.4%) and care expensive (7.6%). 96 cases (66.2%) were assisted by Traditional birth attendants, 36 (24.8%) by health workers at home and 13 (9%) by relatives. Vesico-vaginal fistula cases were 203 (96.6%), recto-vaginal fistula 2 (1%) and combination of both fistulae 5 (2.4%).

Conclusion: Obstetric fistula is common among teenage women with poor educational status and barrier to health services. Zamfara state government should support girl child education and ensure access to quality health services. Behavioural change/modification and increase awareness of people on the dangers of obstetric fistula are essential.

Keywords: Obstetric fistula, home delivery, prolonged labour, Zamfara state, Nigeria