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刚果民主共和国北部所见的产科膀胱阴道瘘:一项描述性研究。

Obstetric vesico-vaginal fistulae seen in the Northern Democratic Republic of Congo: a descriptive study.

作者信息

Paluku Justin L, Carter Tamar E

机构信息

HEAL Africa Tertiary Hospital, Obstetrics and Gynaecology.

University of Florida, Genetics Institute; University of Florida, Department of Anthropology.

出版信息

Afr Health Sci. 2015 Dec;15(4):1104-11. doi: 10.4314/ahs.v15i4.8.

Abstract

BACKGROUND

The Democratic Republic of Congo (DRC) is a developing country with poor obstetric indicators. Despite ongoing efforts to improve care, women continue to suffer multiple complications of child birth including vesico-vaginal fistulae (VVF).

OBJECTIVE

To describe socio-demographic and clinical characteristics of VVF patients in Northern DRC.

METHODS

Women presenting at two VVF mobile surgical campaign missions in the province of Equateur in Northern DRC in August 2012 and October 2013 were examined and treated for VVF. We collected socio-demographic data, including marital status, education, and accompaniment by husbands for treatment, as a proxy for marital support, and clinical data related to characteristics of VVF in patients, duration of illness, and the outcome of treatment surgery.

RESULTS

Out of 163 VVF patients, 100 (61.3%) were less than 35 years old, 102 had no formal education ( 62.6%), and 100 were married ( 61.3%). The mean duration of illness before surgery was 8.4 years. Successful surgery rate for VVF was 87.1% (142/163). A majority of patients who were married, were accompanied to the hospital by their husbands for treatment (56/100; 56.00%). Association analysis revealed age was the only variable that maintained significant association with duration of illness after multivariate analysis (p-value <0.0001). Marital status was the only variable associated with surgical outcome (0.334, 95% CI 0.125- 0.847, p-value = 0.021).

CONCLUSION

We found that most VVF patients were young adults, not educated, and married. Marital status and age may have important roles in outcome of VVF surgery and duration of illness, respectively.

摘要

背景

刚果民主共和国是一个产科指标较差的发展中国家。尽管一直在努力改善医疗服务,但妇女仍遭受分娩的多种并发症,包括膀胱阴道瘘(VVF)。

目的

描述刚果民主共和国北部VVF患者的社会人口统计学和临床特征。

方法

对2012年8月和2013年10月在刚果民主共和国北部赤道省的两次VVF移动外科手术任务中就诊的妇女进行了VVF检查和治疗。我们收集了社会人口统计学数据,包括婚姻状况、教育程度以及丈夫陪同治疗情况(作为婚姻支持的替代指标),以及与患者VVF特征、病程和治疗手术结果相关的临床数据。

结果

在163例VVF患者中,100例(61.3%)年龄小于35岁,102例未接受过正规教育(62.6%),100例已婚(61.3%)。手术前的平均病程为8.4年。VVF的手术成功率为87.1%(142/163)。大多数已婚患者由丈夫陪同到医院治疗(56/100;56.00%)。关联分析显示,多变量分析后,年龄是唯一与病程保持显著关联的变量(p值<0.0001)。婚姻状况是唯一与手术结果相关的变量(0.334,95%置信区间0.125 - 0.847,p值 = 0.021)。

结论

我们发现大多数VVF患者为年轻成年人,未受过教育且已婚。婚姻状况和年龄可能分别在VVF手术结果和病程中起重要作用。

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