Acta Scientific Medical Sciences (ISSN: 2582-0931)

Research Article Volume 4 Issue 7

The Management of Obstetric Fistulae: A 5-Year Integrated Approach Decreases the Incidence in a Health District of DRC

Loposso Nkumu Matthieu1*, Ndundu Jean2, Lufuma Lwa Nkandi Simon1, Punga Maole Monga-Lembe Augustin1 and De Ridder Dirk3

1Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo
2Saint Luc Hospital Kisantu, Kisantu, Democratic Republic of the Congo
3UZ Leuven, Leuven, Belgium

*Corresponding Author: Loposso Nkumu Matthieu, Kinshasa University Hospital, Kinshasa, Democratic Republic of Congo.

Received: April 11, 2020; Published: June 29, 2020

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Abstract

Objective: To determine the impact of a structured, organized and integrated fistula (Solfa, Unikin, St. Luc hospital, Lumos KUL) care program in lowering the incidence of obstetric vesico-vaginal fistula in a district hospital in DR Congo.

Materials and Methods: Several Fistula campaigns were organized by SOLFA between 2008 - 2012. A database of all fistula patients was kept, containing their demographic and administrative data next to clinical data. The hospital yearly report of obstetric activity in Kisantu has been reviewed from 2008 to 2012.

The analysis of some epidemiological parameters (age, the original residence, the distance between the residence and fistula hospital, the year of treatment and the primary fistula or a recurrence) allowed to estimate the incidence per year in the Kisantu health district .

Results: 218 patients consulted in St. Luc hospital between 2008 and 2012 for obstetrics fistulae. 43 patients had a primary fistula (19,75%). The number of patients with VVF from Kisantu compared with those living outside of Kisantu decreased over time. The incidence of new VVF compared with the recurrent/persistent VVF decreased as well, while there was increase in the rate of recurrent fistulas. The mean distance patients travelled to the fistula center increased over time.

Conclusion: The integrated management (Solfa, Unikin, St.Luc hospital, LUMOS KUL) is characterized by a pro-active practice of obstetrics and has significantly contributed to the decrease in numbers of VVF. The increasing numbers of VVF from remote areas indicate that overall health system and especially the obstetric care has to be improved to avoid late treatment.

Keywords: New Fistula; Recurrent Fistula; Curative Setting

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References

  1. Christopher JH., et al. “The Aetiology, treatment and Outcome of Urogenital Fistulae managed in Well- And Low-resourced Countries: A Systematic Review”. European Urology 3 (2016): 478-492.
  2. Delamou A., et al. “Good clinical outcomes from a 7-year holistic programme of fistula repair in Guinea”. Tropical Medicine and International Health 6 (2015): 813-819.
  3. Andersson KE. “Pharmacological treatment of urinary incontinence”. In: Incontinence, sixth, Eds. Abrams P, Cardozo L, Wagg A, Wein A (2017): 805-858.
  4. Chen CCG., et al. “Validation of an obstetric fistula screening questionnaire in rural Nepal: a community‐based cross‐sectional and nested case–control study with clinical examination”. BJOG: An International Journal of Obstetrics and Gynaecology 124 (2017): 955-964.
  5. Ahmed S., et al. “Prevention and Treatment of Obstetric Fistula: Identifying Research Needs and Public Health Priorities”. International Journal of Gynecology and Obstetrics 99 (2007): 1-3.
  6. Wright J., et al. “The changing face of obstetric fistula surgery in Ethiopia”. International Journal of Women's Health 8 (2016): 243-248.
  7. Wall LL. “Obstetric vesicovaginal fistula as an international public”. The Lancet 368 (2006): 1201-1209.
  8. De Ridder. “Fistulas”. In: Incontinence, sixth, Editions. Abrams P,Cardozo L, Wagg A, Wein A (2016): 2043-2203.
  9. Muleta M. “Obstetric Fistula in Developing Countries: A Review Article”. Journal of Obstetrics and Gynaecology Canada 11 (2006): 962-966.
  10. De Bernis L. “Obstetric fistula: guiding principles for clinical management and programme development, a new WHO guideline”. The International Journal of Gynecology and Obstetrics 99 (2007): S117-S121.
  11. Paluku JL and Carter TE. “Obstetric vesico-vaginal fistulae seen in the Northern Democratic Republic of Congo: a descriptive study”. African Journal4 (2015): 1104-1111.
  12. Muleta M., et al. “Obstetric fi stula in 14, 928 Ethiopian women”. Asia Oceania Geosciences Society 89 (2010): 945-951.
  13. Umoiyoho AJ., et al. “Obstetric Fistula Repair: Experience with Hospital-Based Outreach Approach in Nigeria”. Global Journal of Health Science 5 (2012): 40-45.
  14. Loposso MN., et al. “Obstetric fistula in a district hospital in DR Congo: Fistula still occur despite access to caesarean section”. Neurourology and Urodynamics 5 (2015): 434-437.
  15. Melah GS., et al. “Risk factors for obstetric fistulae in north-eastern Nigeria”. Journal of Obstetrics and Gynaecology (2009): 819-823.
  16. Donnay F and Ramsey K. “Eliminating obstetric fistula: progress in partnerships”. International Journal of Clinical Obstetrics and Gynaecology 94 (2006): 254-261.
  17. De Ridder D. “Fistula in the developing world”. In: Incontinence, fourth, Editions: Abrams P, Cardozo L, Khoury S WA, editor (2009): 1419-1458.
  18. Khisa W., et al. “Understanding the lived experience of women before and after fistula repair: a qualitative study in Kenya”. BJOG: An International Journal of Obstetrics and Gynaecology3 (2017): 503-510.
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Citation

Citation: Loposso Nkumu Matthieu., et al. “The Management of Obstetric Fistulae: A 5-Year Integrated Approach Decreases the Incidence in a Health District of DRC".Acta Scientific Medical Sciences 4.7 (2020): 49-53.



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