Kozhumam Arthi, Bountogo Mamadou, Palmer Dina Goodman, Grieg Carolyn, Inghels Maxime, Agyapong-Badu Sandra, Osborne Cristina, Harling Guy, Bärnighausen Till, Rapp David, Beestrum Molly, Davies Justine, Hirschhorn Lisa R
Northwestern University Feinberg School of Medicine, Robert J. Havey Institute for Global Health, Chicago, IL, United States.
Centre de Recherche en Santé de Nouna, Burkina Faso, London, United Kingdom.
Front Glob Womens Health. 2025 Jan 6;5:1511444. doi: 10.3389/fgwh.2024.1511444. eCollection 2024.
The prevalence of urinary incontinence (UI) in older women in low- and middle-income countries (LMICs) is not well understood. We conducted a rapid literature review to assess the burden of UI in this population and contextualize findings from a household survey of women aged 40 and older in Nouna, in northwestern Burkina Faso. The rapid review included 21 survey articles. UI prevalence for LMIC women 40 or older varied greatly (6%-80%), with differences by socio-demographics, gynecological factors (menopausal status, birth outcomes), comorbidities (age, education, obesity, diabetes, hypertension, arthritis), behaviors (smoking status) and survey location. The studies used validated tools-the International Consultation on Incontinence Urinary Incontinence Short Form (ICIQ UI-SF) was most common ( = 4, 19%)-and bespoke tools that have not yet been validated. In Nouna, 983 (64.5%) of 1,524 women, completed the ICIQ UI-SF. Overall UI prevalence, defined as reporting leakage at least 2-3 times a week, was 2.6% (95% CI 1.73%-3.85%), descriptively increased with age from 0.5% in 40-49 year-olds to 6.6% in those 70 and over. Of those with UI, 88.5% experienced leakage daily, and 50% reported moderate or greater interference with daily life, yet most (88.5%) had not spoken to a healthcare provider. Multivariable analysis revealed that UI was more common among women who were not currently married and decreased with higher education levels. Both the rapid review and survey highlight the burden of UI among older women in LMICs, particularly as they age beyond 60. Given UI's association with physical and mental health, it is crucial to raise awareness of its burden, improve healthcare access, and integrate routine screening into basic healthcare services. Additionally, training healthcare providers and developing culturally appropriate interventions will help address stigma and ensure effective management of UI in this vulnerable population.
中低收入国家（LMICs）老年女性尿失禁（UI）的患病率尚不清楚。我们进行了一项快速文献综述，以评估该人群中尿失禁的负担，并结合布基纳法索西北部努纳地区对40岁及以上女性进行的家庭调查结果进行分析。快速综述纳入了21篇调查文章。40岁及以上的中低收入国家女性尿失禁患病率差异很大（6%-80%），因社会人口统计学、妇科因素（绝经状态、生育结局）、合并症（年龄、教育程度、肥胖、糖尿病、高血压、关节炎）、行为（吸烟状况）和调查地点而异。这些研究使用了经过验证的工具——国际尿失禁咨询委员会尿失禁简表（ICIQ UI-SF）最为常用（n = 4，占19%）——以及尚未经过验证的定制工具。在努纳，1524名女性中有983名（64.5%）完成了ICIQ UI-SF。总体尿失禁患病率定义为每周至少报告漏尿2-3次，为2.6%（95%CI 1.73%-3.85%），从描述性来看，患病率随年龄增长而增加，从40-49岁人群中的0.5%增至70岁及以上人群中的6.6%。在尿失禁患者中，88.5%的人每天都有漏尿，50%的人报告对日常生活有中度或更大干扰，但大多数人（88.5%）尚未与医疗服务提供者交谈过。多变量分析显示，尿失禁在未婚女性中更为常见，且随着教育水平的提高而降低。快速综述和调查均凸显了中低收入国家老年女性尿失禁的负担，尤其是在她们60岁以后。鉴于尿失禁与身心健康相关，提高对其负担的认识、改善医疗服务可及性并将常规筛查纳入基本医疗服务至关重要。此外，培训医疗服务提供者并制定适合当地文化的干预措施将有助于消除污名化，并确保对这一弱势群体的尿失禁进行有效管理。
