Abstract
Vaginal fistula is a shattering maternal complication characterized by an anomalous opening between the bladder and/or rectum and vagina resulting in continuous leakage of urine or stool. Although prevalent in Ethiopia, its magnitude and distribution is not well studied. We used statistical mapping models using 2005 and 2016 Ethiopia Demographic Health Surveys data combined with a suite of potential risk factors to estimate the burden of vaginal fistula among women of childbearing age. The estimated number of women of childbearing age with lifetime and untreated vaginal fistula in 2016 were 72,533 (95% CI 38,235–124,103) and 31,961 (95% CI 11,596–70,309) respectively. These figures show reduction from the 2005 estimates: 98,098 (95% CI 49,819–170,737) lifetime and 59,114 (95% CI 26,580–118,158) untreated cases of vaginal fistula. The number of districts having more than 200 untreated cases declined drastically from 54 in 2005 to 6 in 2016. Our results show a significant subnational variation in the burden of vaginal fistula. Overall, between 2005 and 2016 there was substantial reduction in the prevalence of vaginal fistula in Ethiopia. Our results help guide local level tracking, planning, spatial targeting of resources and implementation of interventions against vaginal fistula.
Highlights
Vaginal fistula is a shattering maternal complication characterized by an anomalous opening between the bladder and/or rectum and vagina resulting in continuous leakage of urine or stool
There was no significant difference in the median of prevalence of untreated fistula between rural and urban communities across regions neither in 2005 (Wilcoxon’s test, p-value = 0.7545) nor in 2016 (Wilcoxon’s test, p-value = 0.1843)
When we compared the prevalence of lifetime fistula in rural and urban areas between years, we observed no difference in the prevalence in rural areas (Wilcoxon’s test, p-value = 0.3381) whereas the prevalence in urban areas declined sharply from 2005 to 2016 (Wilcoxon’s test, p-value < 0.05)
Summary
Vaginal fistula is a shattering maternal complication characterized by an anomalous opening between the bladder and/or rectum and vagina resulting in continuous leakage of urine or stool. The estimated number of women of childbearing age with lifetime and untreated vaginal fistula in 2016 were 72,533 (95% CI 38,235–124,103) and 31,961 (95% CI 11,596–70,309) respectively. Campaign to End Obstetric Fistula was launched in 2003 by The United Nations Population Fund and its implementing partners that sets an agenda for ‘the elimination of obstetric fistula’ in high burden countries[5]. In line with this global commitment, Ethiopia have targeted to eliminate obstetric fistula by 20206.
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